Time to Lithotripsy; Determining whether patients referred for Lithotripsy received their first treatment within timeframes outlined by NICE guidelines and local protocols
BAUS ePoster online library. Donnan F. 06/23/21; 319055; p14-7
Disclosure(s): No conflicts of interest to declare
Fiona Donnan
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Abstract
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Introduction
This audit aims to determine whether patients referred for ureteric and renal lithotripsy received their first treatment in the timeframes outlined by NICE guidelines and local protocols.
Patients (or Materials) and Methods
This clinical audit was carried out at a regional Lithotripsy unit. Patients data was collated using clinical information systems. Radiology information systems were interrogated to collect electronically archived referral and treatment data.
Results
Consecutive patients from July to August 2020 were included (n=62). For ureteric stones, median CT to treatment time was 4 days (IQ range 2-9) and referral to treatment 3 days (IQ range 1-4). Times to treatment were not significantly different between referring hospitals when assessed with T-Test. Median time from CT to treatment for emergency ureteric stones was 3 days (IQ range 2-4.5). Compliance with guidelines and protocols is displayed in Table 1.
Conclusions
Of patients referred for emergency ureteric lithotripsy, 77% were treated within 48 hours and 87% of urgent cases were treated within 7 days from referral. If time of CT is used as the 48 hours pathway start, 38% had emergency ureteric lithotripsy within NICE timeframes. Causes for delays included anticoagulant washout time, equipment downtime, patient choice of appointment and weekends unit closure.
This study demonstrates current performance to NICE guidelines. The delay from CT to emergency lithotripsy highlights that pathways should be in place for immediate Urologist review when obstructing stones are diagnosed. An improved metric for defining treatment pathways may be imaging diagnosis to clearance.
This audit aims to determine whether patients referred for ureteric and renal lithotripsy received their first treatment in the timeframes outlined by NICE guidelines and local protocols.
Patients (or Materials) and Methods
This clinical audit was carried out at a regional Lithotripsy unit. Patients data was collated using clinical information systems. Radiology information systems were interrogated to collect electronically archived referral and treatment data.
Results
Consecutive patients from July to August 2020 were included (n=62). For ureteric stones, median CT to treatment time was 4 days (IQ range 2-9) and referral to treatment 3 days (IQ range 1-4). Times to treatment were not significantly different between referring hospitals when assessed with T-Test. Median time from CT to treatment for emergency ureteric stones was 3 days (IQ range 2-4.5). Compliance with guidelines and protocols is displayed in Table 1.
Conclusions
Of patients referred for emergency ureteric lithotripsy, 77% were treated within 48 hours and 87% of urgent cases were treated within 7 days from referral. If time of CT is used as the 48 hours pathway start, 38% had emergency ureteric lithotripsy within NICE timeframes. Causes for delays included anticoagulant washout time, equipment downtime, patient choice of appointment and weekends unit closure.
This study demonstrates current performance to NICE guidelines. The delay from CT to emergency lithotripsy highlights that pathways should be in place for immediate Urologist review when obstructing stones are diagnosed. An improved metric for defining treatment pathways may be imaging diagnosis to clearance.
Introduction
This audit aims to determine whether patients referred for ureteric and renal lithotripsy received their first treatment in the timeframes outlined by NICE guidelines and local protocols.
Patients (or Materials) and Methods
This clinical audit was carried out at a regional Lithotripsy unit. Patients data was collated using clinical information systems. Radiology information systems were interrogated to collect electronically archived referral and treatment data.
Results
Consecutive patients from July to August 2020 were included (n=62). For ureteric stones, median CT to treatment time was 4 days (IQ range 2-9) and referral to treatment 3 days (IQ range 1-4). Times to treatment were not significantly different between referring hospitals when assessed with T-Test. Median time from CT to treatment for emergency ureteric stones was 3 days (IQ range 2-4.5). Compliance with guidelines and protocols is displayed in Table 1.
Conclusions
Of patients referred for emergency ureteric lithotripsy, 77% were treated within 48 hours and 87% of urgent cases were treated within 7 days from referral. If time of CT is used as the 48 hours pathway start, 38% had emergency ureteric lithotripsy within NICE timeframes. Causes for delays included anticoagulant washout time, equipment downtime, patient choice of appointment and weekends unit closure.
This study demonstrates current performance to NICE guidelines. The delay from CT to emergency lithotripsy highlights that pathways should be in place for immediate Urologist review when obstructing stones are diagnosed. An improved metric for defining treatment pathways may be imaging diagnosis to clearance.
This audit aims to determine whether patients referred for ureteric and renal lithotripsy received their first treatment in the timeframes outlined by NICE guidelines and local protocols.
Patients (or Materials) and Methods
This clinical audit was carried out at a regional Lithotripsy unit. Patients data was collated using clinical information systems. Radiology information systems were interrogated to collect electronically archived referral and treatment data.
Results
Consecutive patients from July to August 2020 were included (n=62). For ureteric stones, median CT to treatment time was 4 days (IQ range 2-9) and referral to treatment 3 days (IQ range 1-4). Times to treatment were not significantly different between referring hospitals when assessed with T-Test. Median time from CT to treatment for emergency ureteric stones was 3 days (IQ range 2-4.5). Compliance with guidelines and protocols is displayed in Table 1.
Conclusions
Of patients referred for emergency ureteric lithotripsy, 77% were treated within 48 hours and 87% of urgent cases were treated within 7 days from referral. If time of CT is used as the 48 hours pathway start, 38% had emergency ureteric lithotripsy within NICE timeframes. Causes for delays included anticoagulant washout time, equipment downtime, patient choice of appointment and weekends unit closure.
This study demonstrates current performance to NICE guidelines. The delay from CT to emergency lithotripsy highlights that pathways should be in place for immediate Urologist review when obstructing stones are diagnosed. An improved metric for defining treatment pathways may be imaging diagnosis to clearance.
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