Does clinical validation and the implementation of new models of outpatient service delivery have the potential to reduce waiting lists? A pilot study in Letterkenny University Hospital

Lonergan, Peter E.; Logan, Jamie; Diver, Sean; Nugent, Colette; Hegarty, Ita; Plunkett, Oliver; Mealy, K.; Hyland, John; McNamara, Deborah A.; Rogers, Eamonn

doi:10.1007/s11845-020-02183-w

Cited by 2 publications

(2 citation statements)

References 9 publications

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“…Following on from a successful pilot implementation in a Model 3 hospital in Letterkenny, we hypothesised that establishing a nurse-led LUTS clinic in a Model 4 hospital would significantly reduce waiting times for patients, improve access to urological care and reduce the overwhelming burden currently experienced in general urology outpatient clinics [4]. The aim of our pilot study was to objectively demonstrate that urology nurse specialists can safely run a benign urology clinic in well-prepared settings.…”

Section: Introductionmentioning

confidence: 99%

Implementation of a nurse-led lower urinary tract symptoms (LUTS) clinic reduces general urology clinic workload in a Model 4 Hospital: a pilot study in Tallaght University Hospital

et al. 2020

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Background With among the lowest urologist per population ratios in Europe, the demand for urology specialist review in Ireland far exceeds supply. Lower urinary tract symptoms (LUTS) account for a significant number of referrals. The traditional paradigm of every patient being reviewed in a consultant-led clinic is unsustainable. New models of care with nurse-led clinics represent an opportunity to optimise limited resources. Methods Existing long-waiting male LUTS referrals were triaged to a specialist nurse-led LUTS clinic. After urology CNS assessment, charts were reviewed by a consultant urologist and a plan formulated. Relevant data were prospectively collected and analysed. Results Fifty-eight new male patients with LUTS were seen over a 6-month period with an average waiting time of 15.8 months. Patients were assessed with uroflowmetry, IPSS and DRE. Mean age was 64, IPSS 14.5, Qmax 18.3 ml/s and PVR 89 ml. Thirty patients (52%) were discharged directly with lifestyle modification and medical therapy. Twenty-eight patients (48%) required one or more further investigations and subsequent review; 11 had flexible cystoscopy, 4 had urodynamics, 5 had prostate MRI, and 2 patients were listed for surgery (TURP and circumcision). The remaining 10 patients were for review post trial of lifestyle modifications and/or medical treatment. After review/investigations, 4 more patients were discharged. A total of 32 patients (55%) were discharged or listed for surgery after initial assessment. This total increased to 62% after a second review/investigations. Conclusion Introduction of a CNS-led LUTS clinic has significantly reduced the number of patients requiring follow-up in general urology clinics, representing a quality improvement in service provision. Supplementary Information The online version contains supplementary material available at 10.1007/s11845-020-02428-8.

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Section: Introductionmentioning

confidence: 99%

Implementation of a nurse-led lower urinary tract symptoms (LUTS) clinic reduces general urology clinic workload in a Model 4 Hospital: a pilot study in Tallaght University Hospital

et al. 2020

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“…This project investigated new service delivery models that promote advanced and extended scope of practice of allied health practitioners. The consideration of such models was driven by their success in reducing waiting lists and waiting times in other health‐care fields including nursing 3 and physiotherapy 4 …”

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confidence: 99%

Can an advanced audiology‐led service reduce waiting times for paediatric ear nose and throat outpatient services?

Pokorny

Thorne

Whitfield

et al. 2020

J Paediatrics Child Health

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Aim Children with middle ear disease often experience lengthy delays waiting for outpatient paediatric ear nose and throat (ENT) services. This study aimed to investigate whether an alternative service delivery model using audiologists working in an expanded scope of practice reduced waiting times for children to access such services. Methods A total of 131 children consecutively referred to a large ENT outpatient service in Queensland, Australia, for middle ear and hearing concerns were prospectively allocated to either a standard ENT service or an advanced audiology (AA)‐led service. Waiting times and attendance rates were collected and compared between the two patient groups. Results The median waiting time from referral to first offered appointment was 96 days for children in the AA‐led service versus 417.5 days for children in the standard ENT service. Seventy‐nine percent of children in the AA‐led service attended their first offered appointment versus 61% in the standard ENT service. For children receiving grommets, the median waiting time from initial referral to grommet insertion was 226 days for children in the AA‐led service versus 627 days for children in the standard ENT service. Conclusion The AA‐led service was an effective alternative pathway to reduce waiting times for children referred to ENT services with middle ear and hearing concerns.

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Does clinical validation and the implementation of new models of outpatient service delivery have the potential to reduce waiting lists? A pilot study in Letterkenny University Hospital

Cited by 2 publications

References 9 publications

Implementation of a nurse-led lower urinary tract symptoms (LUTS) clinic reduces general urology clinic workload in a Model 4 Hospital: a pilot study in Tallaght University Hospital

Implementation of a nurse-led lower urinary tract symptoms (LUTS) clinic reduces general urology clinic workload in a Model 4 Hospital: a pilot study in Tallaght University Hospital

Can an advanced audiology‐led service reduce waiting times for paediatric ear nose and throat outpatient services?

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