Introduction: Models of care that use allied health practitioners working in an extended scope of practice (ESP) as the first point of contact for patients have proven effective in managing waitlist demand in a range of specialties. The dietitian‐led gastroenterology clinic (DLGC) was one of a number of initiatives undertaken in our hospital and health service (HHS) to address growing demand for gastroenterology services.

Methods: An audit of gastroenterology waitlists was performed before the clinic was established, and DLGC‐eligible patients were identified based on the 2016 Queensland Gastroenterology Clinical Prioritization Criteria. A business case for service implementation was developed, and DLGC‐eligible patients were offered appointments in the clinic from June 2016. After clearance of the initial backlog, ongoing triaging and reallocation to the DLGC was conducted by the gastroenterology consultant. A mixed‐methods approach was used to evaluate service activity and waitlists, DLGC patient characteristics, and patient satisfaction between June 2016 and March 2018.

Results: The DLGC eligibility criteria included category 2 patients; patients <50 years of age and patients presenting with dyspepsia or heart burn, reflux, abdominal pain, constipation, diarrhea, or altered bowel habits and with no alarm symptoms. A comparison of patient wait times before and after clinic establishment was conducted against a background of rising service demand, with a 20% annual increase in gastroenterology referrals to the HHS. Over the first 21 months of operation, 827 patients met the inclusion criteria and were triaged to the DLGC. This represented 6.8% of all gastroenterology referrals and 20.1% of all category 2 gastroenterology patients. A total of 561 new patients (72% female) and 518 review patients were seen in the DLGC clinic. There were 154 patients who were removed from the gastroenterology waitlists after failing to respond to appointment offers. The remainder had future appointments booked (n = 47) or were on the waitlist (n = 65). The dietitian organized screening pathology under ESP and provided lifestyle management strategies. In March 2018, 396 patients (70%) had been discharged to the care of their general practitioners with satisfactory resolution of symptoms. Fifty‐three patients (9.4%) were identified as requiring medical review during assessment in the DLGC and were expedited to the gastroenterologist. Since establishment of the service, the average wait times for DLGC‐eligible patients reduced from 160 to 61 days. The number of patients in breach of clinically recommended wait times reduced from 74.6% (median breach days, 92) to zero. The average time from referral to discharge in the DLGC was 110 days, with an average treatment time of 50 days. Patients received an average of 2.3 occasions of service within the DLGC. Patient surveys indicated a high level of satisfaction with the service. Enablers for successful establishment of the DLGC included alignment with broader HHS strategic objectives, positive relationships between stakeholders, strong support from management, and an opt‐out process.

Conclusions: A model for the formation of a DLGC that has improved patient flow, along with enablers for successful implementation, has been established. This may be used elsewhere to address outpatient gastroenterology service demand pressures.