Streamlining of Division of O&G CIAF workflow & responsibilities of Department Safety champs

​Streamlining of Division of O&G CIAF workflow & responsibilities of Department Safety champs

Project team members: Dr Suzanna Sulaiman, Dr Rajeswari Kathirvel, Mr Bryan Lim, Ms Fiona Low, Ms Lun Hwee Leng, Ms Shirlene Tang and Ms Jeslyn Neo.

The Clinical Indicator Audit Form (CIAF) started since year 2022 whereby clinicians put up these forms to document cases that fulfilled certain criteria, e.g, Injury, repair, or unplanned removal of organ during surgery, Birth Trauma etc. CIAFs were put up for HODs and Division Chair to review care processes, identify lapses and ensure close loop follow up of these patients. However, this routing process in manual; problems faced were slow follow ups and lost forms.

The team introduced a standardized workflow to reduce unfamiliarity. Originally the CIAF forms from different areas are sent to QSRM and QSRM will update the system and route to respective tag-consultants through OG admin staff. The CIAF form will route to tag-consultant who may not be seeing the patient at all which delay the signing process due to wrong routing. With the new implemented workflow of letting O&G admin staff to route the CIAF form, the team aim to reduce the number of days taken to return CIAFs at 90^th percentile from 161 days to 80 days in 6 months and reduce the % of no-returns CIAF forms from 29% (Baseline) to 15% in 6 months.    

The introduction of new workflow was well-received, at 90^th percentile, the number of days taken went from 161 days to 59days or less. The % of no returns CIAFS reduced from 29% to 14%.

The team was successful in implementing the new workflow. It is important to continuously look into meeting clinical indicators and improvement process. This allows any healthcare organization to continue to ensure that appropriate care process is in place, lapses are looked into, and changes are made to overcome them and finally ensure all loops are closed in any care plans of patients. With the development of time, even when the collection of CIAF progress towards electronically, it is imperative for a designated individual to be the main liaison individual to keep track of the process.