I have had a number of appointments at the Logan Hospital outpatients department.

To be able to get an initial appointment I had to get a referral from my GP. But the hospital only accept the referral by Fax. There is no way of doing so via email, as according to the Qld health department, email is not a secure form of communication, but fax and postage apparently is.

I get a letter sent to me in the post basically saying I have an appointment offer, that I have to confirm by ringing the outpatients department to a number given on the letter. The number is shown 4 times on the letter as is a fax number shown 2 times.

On ringing the number I get a voice response system that provides some information,

it initially says, if I want to speak to someone I should please hold the line. But because of the high number of calls that the wait time may be more than 10 minutes.

it then goes on to say press 1 now, then ther is a slight hesitation in the voice after which it says if you wish to leave a message please supply certain information.

it is confusing as to whether I should press 1 to speak to someone or I should hold on.

If then says to press 2 now, without any further explanation.

does that mean I have to press 2 in all situations or only if I want to leave a message? or is it 1 to leave a message? what is it to not leave message?

After ringing the number a number of times I discovered that if I press 1 or 2 it goes to another message that asked me to leave certain information. The only way to get to talk to somebody is to press nothing.

but when I do press nothing and just hold the line, I inevitably get a message to say I am 9th in the queue. At that point there is no way of going back to leave a message, other than ringing again. at a later point, when you have held on for some time and may have progressed through the queue, there is an option to leave a message.

my recent experience was that I had to wait 40 minutes to get to speak to someone.

after going through a situation where I held on the phone for 40 minutes to speak to somebody I decided to leave a message

I have on successive days, 3 times left a message and have not had my message responded to.

after waiting for 40 minutes to speak to someone I asked the person to change my physical appointment to a telephone appointment. they initially said they will cancel my appointment and make another one. to which I said I did not want that to happen as I would lose my place in the waiting list, rather I just wanted to change the form of the appointment. I was told that she would leave a message to that effect with the doctor.

the appointment time was 10 a.m

from 10 a.m. to 10:45 I was waiting for the call. at 11:10 I got a phone call, from a private number, where my phone rang 3 times and as I was about to answer it it hung up. I assume that was a doctor calling.

the next 3 days in a row I left a message on the answering service service. but never got a reply.

the fourth time I rang the number at 8 a.m. the responses, message said I was first in the queue. however I still have to wait 15 minutes to speak to someone. after explaining what happened the lady looked in the file and said the doctor had made a note to make another appointment in 4 weeks. I suggested considering all had been through that this was unacceptable and wanted appointment a lot sooner than that. she said she would put a note on the file to that affect.

so I still don't know when I'm going to get my appointment.

at the end of conversation with the person, I asked if there was any other number I can ring rather than waiting 40 minutes. she told me there was not and she was aware of the 40-minute delay and she was the only person answering calls. that if I wanted to make a complaint, I should contact consumer liaison.

hence this document.

on 3/8/2020 I got an email from the medical imaging department about an appointment for an MRI. I attended the appointment and no phone calls were required whatsoever. even if I couldn't have made the appointment I could have responded to the email.

so it appears that different sections of the hospital have different methods of making appointments. if one department works efficiently using email, why isn't it possible for all departments to work the same way?

I think they call this “best practice”

1. acknowledgement that this information has been received
2. a timeframe as to when investigation about this will be completed
3. an explanation why emails are used buy some sections of the hospital for appointments and not others
4. preferably, an immediate change so all appointments can optionally be made by email
5. initially,multiple extra resources be given to that poor person that is solely answering those phone calls.
6. counselling for that poor person that is answering the phone, considering that it must be having a detrimental effect on her.
7. initially, changes in the wording of the voice response system to make it far less confusing.
8. abolish the system whereby only fax is used for Dr referrals and replace it with something more efficient. eg the myGov referral system.
9. systems put in place such that there is never a reoccurrence of this situation.

Good afternoon

Further to our email of 6 October 2020 acknowledging receipt of your concerns I would like to provide you with further feedback received from the Practice Manager, Specialist Outpatients in response to the specific questions you raised in your email. Your concerns were forwarded initially to the Practice Manager for their review and feedback.

1. an explanation why emails are used buy some sections of the hospital for appointments and not others.

The use of emails works very well for Specialist Outpatients and this department is able to forward any queries to other areas where appropriate. The Practice Manager was not able to explain why other areas of the hospital do not have this option at this time.

2. preferably, an immediate change so all appointments can optionally be made by email

An immediate change in process is not an option. However, this feedback and suggestion will be discussed with other areas. Specialist Outpatients is centralised however, this is a very large organisation and there are other non-specialist outpatient services that work independently.

3. initially, multiple extra resources be given to that poor person that is solely answering those phone calls.

Outpatient staff resources are finite and other initiatives are in use. A generic email address for Specialists Outpatients (appointmentslgh@health.qld.gov.au) was developed to assist staff with dealing with the number of telephone enquiries. It is recommended this email or message service be used as they are a great alternative to waiting on the phone.

4. counselling for that poor person that is answering the phone, considering that it must be having a detrimental effect on her.

As discussed above there are strategies put in place to assist staff. Should staff require counselling services, this is available to them.

5. initially, changes in the wording of the voice response system to make it far less confusing.

The Practice Manager advised that this will be reviewed in due course.

6. abolish the system whereby only fax is used for Dr referrals and replace it with something more efficient. eg the myGov referral system.

This unfortunately can not be done at a local level and as advised in our previous email, all referrals from General Practitioners (GPs) are to be faxed to the Central Referral Hub for allocation. This is not something individual hospitals can change. This process was developed by Metro South Health to have a mainstream single point of service for GP’s to send patient referrals to Metro South. The Hub then allocate referrals to the hospital that has the required service and considers which catchment area the patient lives.

7. systems put in place such that there is never a reoccurrence of this situation

The Practice Manager appreciated your feedback, and Logan Hospital values consumer feedback and endeavours to undertake continuous improvement reviews and implementation of new initiatives as part of our normal business.

You had also asked that we provide you with details of the message we received when we open the link you provided. As mentioned in our previous email the link you sent was unable to be opened by our service.

Thank you once again for providing your feedback, and sincere apologies again for your experience with our hospital.

Kathy or Consumer liaison officer person, I'm not sure who I'm writing to

thank you for your more detailed reply .

I have now just received a letter from outpatients Logan Hospital metro south health, in relation to another appointment, that requires me to confirm the appointment, but makes no mention whatsoever about doing so by email.

yet in your response you do give an email address.

can I stringently suggest that you put the email address in all letters you send out in relation to appointments, because as you say in the email you sent to me:

“….. was developed to assist staff with dealing with the number of telephone enquiries. It is recommended this email or message service be used as they are a great alternative to waiting on the phone.”

yes it is a great alternative to waiting on the phone. but it is only an alternative if people know about it. other than having written to you I would not know about it. I'm sure there are very few people that know about it.

are you going to add the email address to all future appointment letters? if so when? if not, why not?

because of the new appointment I got, I I rang the number quoted and discovered I was number 6 in the queue. I will now try the email alternative.

as in a previous time when ringing that number I was told by the person concerned that she was the only one answering calls, I assume that if she takes a lunch break, nobody else answers the calls. can you please confirm this?

in relation to all this, can you please explain to me why an immediate change “is not an option”?

if the practice manager is not able to explain why some areas of the hospital do not use email for making appointments, please escalate this matter to a higher person that can explain it.

I understand that out patient resources staff resources are finite. I'm not asking for infinite resources. I'm only asking for an increase in resources, for a system that it is obviously not working efficiently and is creating frustration for your clients.

can you please give me a date of “due course” so I know when to check that the voice response system has been changed to be less confusing?

Re the fax system for doctor referrals. it is possible to have a Central system, that works with emails rather than faxes. whether it's a Central system or any system the method of communication is not relevant.

Re the link I initially sent not being able to be open by your system. I need the exact wording that you get when you click on the link, so I can investigate that from my end.

to make it easy for you here is the link again:

http://greig.homeip.net/doku.php?id=logan_hospital_appointments

please reply answering all questions I have asked.

thank you Geoff Greig

Logan Hospital person,

I have not received a reply from the last email I sent you on 13/10 2020.

I wish to receive a reply to the questions I posed in that email.

I also would like to you answer the following questions.

on 2/2/2021 I received an SMS message, informing me I have an appointment at the hospital on Tuesday the 9th of February 2021. the text asked me to reply with the letter “Y” to confirm the appointment. which I did. today Tuesday the 9th of February 2021, I received a letter offering me that same appointment.

why did I receive a letter when I had already accepted the appointment via SMS message 7 days earlier?

the letter I received told me to confirm the appointment before 16/2/2021. why are letters being sent out asking to confirm an appointment by a date which is 7 days after the date of the appointment?

if the answer to the above question is because of a computer system, why is not the computer system changed to stop it from happening?

on the letter I received I notice what appears to be a red stamp stating: “did you know you can email us? appointslgh@healtg.qld.gov.au”. is this that being manually put on each letter?

I also noticed that there is a label stuck on the bottom right hand corner of the letter in relation to Covid-19. is this being mainly stuck on every letter?

if the answer to either of the above two questions is yes then why is not the system that generates these letters being changed to incorporate the information automatically?

if you're not ableto answer these questions by 12/2/2021 please acknowledge that you have received this email and indicate to me,via return email, when you will be answering the questions in this email and my previous email.

Thanks. Geoff Greig

Justine admin person in outpatients rang me, 10/2/2021, finished call about 4:40 pm, and we spoke for quite some time in relation to all the problems in the emails.she said she had previously attempted to do something about them,but her either come up with brick walls because of ther IT systems or have been waiting for months for something to happen. hence I said I will contact my local member. so the issues gets pushed at both ends.

Dear Mr Greig,

In my email on 22 February 2021, I advised that the Administration Manager, Outpatients was to offer further outcomes in relation to improvements which she discussed with you during your phone call on 10 February 2021. The following information has been provided.

In relation to the queries regarding manual additions to letters, the Administration Manager has advised that the outpatients scheduling system is a state-wide system and is used for letter production. These letter scripts pull in relevant information for that individual patient and the appointment / clinic location from various database sources. For letter generation it is also a requirement to be consistent with Department of Health electronic record naming conventions and guidelines. There is some capacity for local customisation, through the relevant Metro South developer team. I can advise that the job for Logan Hospital letter updates has been received and is being progressed for the additional scripting to provide the email address within the letter body automatically.

A sticker has been used for COVID-19 information as the situation and relevant information per Department of Health requirements is updated regularly, sometimes at very short notice, and this was considered to be an appropriate approach in this context to keep patients advised of changes that may impact their appointment at Specialist Outpatient Department.

In relation to the use of email confirmation of appointments, this is operational in the specialist outpatient area, and your feedback regarding the potential benefit of such a system will be provided to other areas of the hospital for consideration. There are a large range of services provided by the organisation and it may be that this is not suitable, or appropriate, for all areas.

In relation to your query regarding coverage of the phone system, the Administration Manager has advised that there are currently three staff who work within in that area and that there are plans in place to cover breaks as well as staff leave.

In relation to the specific instance you have described with being asked to confirm an appointment by a date which is 7 days after the date of the appointment, the Administration Manager has advised that patients with appointments scheduled within the next 10 working days are asked to confirm their attendance by way of SMS Messaging. For appointments scheduled later than 10 working days, an appointment letter is sent. On this occasion the admin officer inadvertently sent you a SMS message and an appointment letter. This process has since been addressed with the staff and we apologise for the oversight on our part.

In relation to your concerns regarding the phone reception recording, the Administration Manager has reviewed the voice recording for Specialist Outpatients Department and expects an updated recording will be in place by early April.

I hope you find the above information helpful.

Kind regards,

Janelle

Consumer Liaison Officer | Clinical Governance Unit

Janelle,

thank you for your email.

however from a client/customer and taxpayers point-of-view, this poses more questions from me.

1. considering the different types of outpatient services that Queensland health provides, why is it that the letter production, for outpatient services ,has to be statewide?

2. Why is it no possible to have multiple specific letter generation systems that fulfill the requirement of being consistent with Department of Health electronic record naming conventions and guidelines?

3. Considering that database mail merge technology has been available for over 40 years, able to be easily operated by an end users, why does the Metro South developer team, need to be involved?

It is good to see some progress is being made on some of the issues that I have brought up.

Thanks

Geoff Greig Brisbane Australia