Surgical outpatient clinics: are we allowing enough time?

Waghorn, Alison

doi:10.1093/intqhc/11.3.215

Cited by 18 publications

(16 citation statements)

References 1 publication

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“…10 In studies of general surgical outpatient clinics, it was found that 27% of patients thought the time spent with their doctor was too short and that 78% of clinics over-ran their schedule time. [11][12][13] A recent audit of 10 consecutive routine urology outpatient clinics showed that the mean time spent with the patient in 2001 was 4.8 minutes, which contrasts sharply with the figure of 7.6 minutes obtained during their departments' previous audit in 1988. 14 15 These data do not sit easily with evidence that shows that the length of time spent with the surgeon is of paramount importance to patients' overall satisfaction of the outpatient clinic process.…”

Section: Discussionmentioning

confidence: 94%

National review of urology outpatient practice in the UK

Gilmore

Shackley

Clarke

et al. 2005

Postgraduate Medical Journal

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Objective: To audit the current UK outpatient workload and compare this to the national standards as set out by the British Association of Urological Surgeons (BAUS) in A Quality Urological Service for Patients in the New Millennium published in October 2000. Participants: 520 UK (NHS) and 21 Republic of Ireland (non-NHS) consultant urologists registered with BAUS in 2000. Main outcome measures: Extent to which consultant urologists are able to comply with guidelines set out by their specialist association, the BAUS and by the Royal College of Surgeons of England. Results: The questionnaire return rate was 61% (318/520; regional range 42%-75%). The median ''routine'' clinics/week was two (1-5) with a mean of 13 (1-40) new and 26 (7-80) follow ups. Fifteen percent (49/318) of consultants worked alone in clinic; of the remainder assistance included specialist registrar 67% (212/318), staff grade/associate specialist 32% (102/318), senior house officer 53% (172/318), and pre-registration house officer 2% (7/318). Only 21% (66/318; regional range 0%-46%) of responding consultants followed the BAUS recommendations for outpatient workload/ manpower. Conclusions: A minority of consultants are able to adhere to the outpatient workload guidelines as set out by BAUS council in 2000. In addition, there appears to be significant variations within and between training regions. Development of this project into a regional audit tool may allow intraregional guideline formation governing hospital outpatient workload. In October 2000, the Council of the British Association of Urological Surgeons (BAUS) in conjunction with the Royal College of Surgeons of England produced the document A Quality Urological Service for Patients in the New Millennium which set out to assist health authorities, trust chief executives, clinical directors, and consultant urologists in planning urological services for their community.1 In part, this set down guidelines on outpatient workload, manpower, and standards of care and its conclusions were intended to apply to all NHS consultant urologists. The outpatient guidelines were produced after a consultation period, were felt to comply with the government's initiatives on improvements in the quality of healthcare, and were broadly consistent with advice issued from other surgical specialty associations and the Royal College of Surgeons.1-3 After a review of the literature, we can find no evidence of a national urological outpatient audit either before or after the publishing of the BAUS guidelines document and there would appear, therefore, to be no benchmarks for future auditing of outpatient workload intensity. This paper seeks to address this deficiency. We conducted a national questionnaire based audit to assess at regional and national levels the current clinic based workload and, in particular, to ascertain whether current outpatient practice reflects national guidelines. METHODSA questionnaire was designed to assess individual consultant's outpatient workload and service provision. In view of the...

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Section: Discussionmentioning

confidence: 94%

National review of urology outpatient practice in the UK

Gilmore

Shackley

Clarke

et al. 2005

Postgraduate Medical Journal

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“…These studies differ from the current service evaluation by reviewing aspects of care in absolute terms, and not comparatively, and therefore cannot be used to determine those steps within the pathway that patients prioritize and that reflect the greatest value in their healthcare journey. However, it is recognized that the nature of the process and environment involved in the patient pathway can also influence the quality of the consultation even if considered of low relative importance, for example by limiting patient-doctor interaction [37].…”

Section: Discussionmentioning

confidence: 99%

An evaluation of patient attitudes to the gastroenterology outpatient experience

Larkins

Windsor²,

Trebble³

2013

European Journal of Gastroenterology & Hepatology

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“…Consequently, this leads to shorter consultation times. It has also been shown that satisfaction among patients and doctors declines rapidly when consultations last under 10 min 6 . Tristram Lesser in a letter to ENT News talks of the perils of seeing too many patients in one clinic session 7…”

Section: Discussionmentioning

confidence: 99%

“…However, the BAOL, in its consultation document, has suggested an average of 14 min per patient 5 . On the basis of other research, it has been argued that a reasonable duration for an appointment at a surgical out‐patient clinic is 20 min for a new appointment and 10 min for a follow‐up 6 …”

Section: Discussionmentioning

confidence: 99%

The effect of GMC guidelines on the length of otolaryngological out-patient clinics in a district general hospital

2002

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The British Association of Otolaryngologists has laid down guidelines on the length of time that should be allocated to an out-patient consultation. The General Medical Council (GMC) has also produced guidelines as to what is to be discussed with a patient during an out-patient consultation. This study was designed to determine what effect adhering to the GMC's guidelines would have on the length of an out-patient consultation. Out-Patient consultations were timed for patients referred with common otolaryngological complaints. The study was then repeated after the researchers had been given specific instructions on what to discuss with the patients to comply with the GMC guidelines. Consultation times more than doubled after application of the GMC guidelines. This study highlights the difficulty of specifically adhering to guidelines from our regulatory body, while attempting to fulfil the demands for consultations, with the existing manpower levels available.

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Surgical outpatient clinics: are we allowing enough time?

Cited by 18 publications

References 1 publication

National review of urology outpatient practice in the UK

National review of urology outpatient practice in the UK

An evaluation of patient attitudes to the gastroenterology outpatient experience

The effect of GMC guidelines on the length of otolaryngological out-patient clinics in a district general hospital

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