Post COVID-19 waitlist reduction in a memory disorder clinic

Introduction: As in-demand, specialty service providers, neuropsychologists and dementia evaluation teams in the Veterans Health Administration often face significant patient backlogs, many of which worsened during the COVID-19 pandemic. As long waitlists can result in delayed care, effective methods for reducing waitlists are essential. The purpose of this clinical quality improvement (QI) project was to increase clinical efficiency by implementing comprehensive criteria to streamline consult management in an interdisciplinary memory disorder clinic within the Central Arkansas VA healthcare system. Methods: This project used a combination of the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework and the practical, robust implementation and sustainability model (PRISM) primarily for implementation purposes. Consult management criteria were developed and chart reviews utilizing these criteria were performed on all referrals to determine if patient needs could be best addressed though the memory clinic or other departments. Results: A total of 195 consults were reviewed between August 2023 and April 2024, with approximately 40% of referrals triaged to other services to appropriately address their needs. Increased administrative support and educating referring providers were also implemented. Consult tracking showed waitlist reduction from approximately 6 months to less than a month with consistent implementation and has been maintained at that level. Conclusions: Overall, implementation of our team's consult management criteria greatly improved efficiency, by reducing the clinic's wait list by prioritizing patients whose needs could be best served by our clinic while providing alternative referrals for patients whose care could be better and more expediently addressed by other services.