Streamlining Sleep Study Access: A Quality Improvement Initiative Utilizing Home Sleep Studies and Virtual Clinics

<bold>Background:</bold> The COVID-19 pandemic exacerbated waiting times for inpatient sleep studies at Peamount Healthcare. Timely intervention for sleep disorders is crucial, given the associated health risks. This project aimed to address the backlog via home sleep studies and expert clinical review, ensuring prompt diagnosis and intervention. <bold>Methods:</bold> Telehealth screenings were conducted for all waitlisted patients to determine further assessment needs. Home studies were ordered for those requiring evaluation, with results reviewed by the consultant and the respiratory cANP to initiate appropriate interventions. <bold>Results:</bold> At the start of the project there was 843 patients on the waiting list. Following the telehealth screening, 72% (n=606) required a sleep study, all of which have been booked. To date 94% (n=567) results are back in Peamount and all have been reviewed. CPAP therapy was commenced in 52% (n=294) and of the CPAP group 45% (n=132) fell into the severe OSA category. Alternative treatments were recommended for 4% (n=21) of patients, while 28% (n=159) necessitated clinic appointments for further review and 20% (n=114) have been discharged. <bold>Conclusions:</bold> To date the waiting list for sleep studies has been completely addressed with 52% of reviewed cases requiring CPAP therapy, indicating a high positivity rate. However, 28% still required clinic follow-up, suggesting that home studies although a good screening tool for OSA, alone may not suffice for a conclusive diagnosis for all patients on the waiting list. <bold>Keywords:</bold> Sleep assessment, sleep study, obstructive sleep apnoea, CPAP