P035 Improving the rheumatology advice line service: a quality improvement project

Abstract Background/Aims The rheumatology advice line service has recently faced a surge in calls, straining resources, clinician workload and availability. To address this, we developed a quality improvement (QI) initiative to understand the current process and identify areas for improvement. We initially aimed to reduce the number of calls by March 2025 and have continued to build on this. Methods We utilised QI tools such as process and waste mapping, and we analysed weekly call volumes and the nature of queries during a snapshot week. This informed our interventions, developed in consultation with stakeholders. We identified three key drivers of change: 1. Logging prescription requests directly with the rheumatology pharmacist; 2. Updating the automated message on the advice line to direct queries to the appropriate team members, preventing duplication of work; 3. Introducing electronic advice line request forms that both patients and clinicians can complete. Requests are automatically uploaded into a shared tracker, visible to all team members, allowing real-time action. Admin and the pharmacist handle their respective queries directly, leaving clinicians time to focus on clinical queries. Instead of calling back all patients, we now use a templated messaging system to confirm receipt and action taken. We created a rheumatology webpage with relevant service information. The advice line forms are accessible through QR code and webpage link. To reduce queries, we issued blood forms valid for a year and shared updated vaccination guidance with GP surgeries. Results Incoming calls have reduced, and clinicians can now focus on addressing clinical queries and conducting more detailed telephone consultations. Letters created as a result are coded as a follow-up clinic activity that generates additional income and eases waitlist pressures. The electronic advice line form for staff was introduced on 28th March and made available to patients from 3rd September. From the introduction until the 7th October, 2433 queries were logged (115 admin-related and 312 prescription requests). Specifically, 1386 queries were handled by specialist nurses, 609 by doctors, 318 by the physician associate, 95 by administrative staff and 25 by the rheumatology pharmacist. Consultant discussions were documented in 165 queries, and 81 of these had been addressed by the administrative team, nurses, or the physician associate. The telephone conversations were undertaken as a follow-up appointment for 118 patients. Letters were generated for 214 queries, and requests for 62 additional clinic appointments were raised. Between April and September, 173 patient text messages were sent confirming actions taken. Conclusion Redirecting queries and reducing duplication of work can reduce the clinician’s workload, enabling a more effective use of existing resources. Innovation and digitalisation have the potential to streamline our services when utilised appropriately. Disclosure N. Padmanabhan: None. B.M. Pais: None. K. Putchakayala: None. C. Amoasii: None.