Same day diagnostic service for new cases of haematuria – a District General Hospital experience

St, Hasan; German, K.; Cd, Derry

doi:10.1111/j.1464-410x.1994.tb07483.x

Cited by 16 publications

(7 citation statements)

References 18 publications

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“…One-stop services are well established practise for haematuria, [8][9][10] as well as in other specialties, [11][12][13] and have been suggested by some authors as ap ossibility for testicular pathology, 4,14 but have not been accepted in this setting as yet. With little evidence that '2-week wait' initiatives impact on survival, 15,16 and growing pressure to find alternative mechanisms of improving services in general, onestop approaches are al ogical progression.…”

Section: Discussionmentioning

confidence: 99%

Prospective Evaluation of a Novel One-Stop Testicular Clinic

Rochester

Scurrell

Parry

2008

annals

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Ann RC oll Surg Engl 2008; 90:5 65-570 565Prior to August 2004, general practitioners (GPs) in East Suffolk were able to investigate patients with scrotal disorders in several ways. Direct referral to the diagnostic imaging department for testicular ultrasound scan followed by ar eport by fax or mail involved several delays for the patient in the diagnostic pathway. Following this, referral to the urologydepartment may then have ensued, resulting in further diagnostic delay.A lternatively,i maging was arranged after consultationw ith as enior urologist, resulting in two separate department visits on three occasions in addition to their initial GP consultation. In 2003, the diagnostic imaging department received 560 requests for scrotal ultrasonography,a nd the waiting time for such ascan, if routine, was in excess of 20 weeks. It was possible, however,ifthe index of suspicion was high, for the investigation to be performed on the same day as the consultation.It was believed that the varied systems for patient evaluation provided neither the best quality service nor utilised resources with maximum efficiency.A ss uch, the patient pathway was redesigned to provide aone-stop service in an attempt to provide rapid and simpler diagnosis and instigation of definitive treatment. Funding was provided by the NHS Modernisation Agency'sA ction On Urology project. Men who were referred by their GP with at esticular or scrotal condition would be reviewed in aj oint sonographer and urology nurse specialist clinic provided entirely within the urology department with rapid open access. This service was to be provided in parallel with established urology general out-patient sessions where consultant urologists , the waitingt ime for routine scrotal assessment approached 6m onths in our hospital. The patients' diagnostic pathway was not uniform and involved several delays between general practitioner,r adiologist and urologist. If malignancy was suspected, patients were seen and assessed within 2w eeks. However,i tw as possible for patients with unsuspected malignancy to have their diagnosis delayed.

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Section: Discussionmentioning

confidence: 99%

Prospective Evaluation of a Novel One-Stop Testicular Clinic

Rochester

Scurrell

Parry

2008

annals

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“…The OSMC aims to see all patients within 30 d of referral, as the importance of investigating haematuria with minimal delay is well established (Hasan et al , ; Ho et al , ; Wallace et al , ). Audit revealed that this was achieved 81% of the time for the first 100 patients, with the range of waiting times between 6 and 50 d. Of the 19 people (19%) who waited longer than 30 d to be seen at OSMC, 7 individuals (7%) experienced delay because they declined or missed the original appointment due to personal commitments or ill health.…”

Section: Waiting Timementioning

confidence: 99%

One stop nurse‐led macroscopic haematuria clinic: waiting times and patient satisfaction

Osborne

Koya

2013

Int J of Uro Nursing

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In 2011, a large District Health Board Hospital in New Zealand established a nurse practitioner-led, one stop macroscopic haematuria clinic (OSMC) in an effort to improve the timeliness and quality of the investigative process offered to individuals referred with macroscopic haematuria. Patients were identified during the referrals triage process and graded to be seen at OSMC within 30 d. The OSMC process allows for completion of all basic investigations (urine microscopy and culture, urine cytology, renal tract ultrasound and flexible cystoscopy) by the end of the single clinic visit. This report outlines the OSMC process and reports on adherence to the 30-d timeframe for the first 100 patients, along with patient satisfaction data from patients 51 to 100. The dates of referral and OSMC visits were recorded prospectively for 100 patients and analysed to determine compliance with the 30-d timeframe. For patients 51-100, an anonymous, self-administered questionnaire was utilized to evaluate satisfaction with pre-appointment information, waiting times, interactions with clinicians and education. Of the first 100 patients at OSMC, 81% were seen within 30 d, with all patients rating the clinic timeframes, processes and personnel highly. While the reliability of the Haematuria Clinic Questionnaire results could have been influenced by multiple factors, the OSMC appears to offer service users timely access to diagnostic investigations with clinics timeframes, processes and personnel they rate highly. While 81% of patients were seen within 30 d, work is needed to increase compliance to 100%. This model of care could be adopted at other public hospitals.

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“…A same-day diagnostic service for new cases of haematuria has successfully been introduced at some hospitals in the UK, resulting in a shorter hospital-based delay and an increase in the number of diagnostic cystoscopies performed within 4 weeks (12).…”

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confidence: 99%