The introduction of a dedicated colic clinic to reduce referral times to patients managed expectantly with acute ureteric colic: a quality improvement project
BAUS ePoster online library. Cullen J. 06/22/21; 319141; pCU-4
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Dr. Jack Cullen
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Abstract
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Introduction
Ureteric colic constitutes a large proportion of acute hospital attendances across the UK. This increasingly common condition puts pressure on urological services, leading to an increase in time to follow up. BAUS guidelines indicate that for patients managed expectantly, a clinic review should be undertaken within four weeks of presentation. This quality improvement (QI) project reports the benefit of a dedicated virtual colic clinic to facilitate a more efficient care pathway and reduce patient waiting times.
Patients & Methods
The first cycle retrospectively analysed patients referred from the Emergency Department (ED) with uncomplicated acute ureteric colic, excluding those admitted for immediate intervention, over a 2-month period in 2019. A further cycle was carried out 12 months later following the introduction of a new dedicated virtual colic clinic with updated ED referral guidance. QI Methodology was followed throughout with the use of PDSA cycles.
Results
The mean time from referral to clinic review reduced from 7.5 weeks to 3.5 weeks. The percentage of patients who were reviewed in clinic within 4 weeks increased from 25% to 82%. The meant time from referral to intervention, including shockwave lithotripsy and primary ureteroscopy reduced from 15 weeks to 5 weeks.
Conclusion
The introduction of a virtual colic clinic to our service has improved the definitive management of ureteric colic for patients managed expectantly. This has reduced waiting times for both clinic review and stone treatment which has enhanced patient experience. This intervention now adheres to the timeline outlined by current BAUS guidance.
Ureteric colic constitutes a large proportion of acute hospital attendances across the UK. This increasingly common condition puts pressure on urological services, leading to an increase in time to follow up. BAUS guidelines indicate that for patients managed expectantly, a clinic review should be undertaken within four weeks of presentation. This quality improvement (QI) project reports the benefit of a dedicated virtual colic clinic to facilitate a more efficient care pathway and reduce patient waiting times.
Patients & Methods
The first cycle retrospectively analysed patients referred from the Emergency Department (ED) with uncomplicated acute ureteric colic, excluding those admitted for immediate intervention, over a 2-month period in 2019. A further cycle was carried out 12 months later following the introduction of a new dedicated virtual colic clinic with updated ED referral guidance. QI Methodology was followed throughout with the use of PDSA cycles.
Results
The mean time from referral to clinic review reduced from 7.5 weeks to 3.5 weeks. The percentage of patients who were reviewed in clinic within 4 weeks increased from 25% to 82%. The meant time from referral to intervention, including shockwave lithotripsy and primary ureteroscopy reduced from 15 weeks to 5 weeks.
Conclusion
The introduction of a virtual colic clinic to our service has improved the definitive management of ureteric colic for patients managed expectantly. This has reduced waiting times for both clinic review and stone treatment which has enhanced patient experience. This intervention now adheres to the timeline outlined by current BAUS guidance.
Introduction
Ureteric colic constitutes a large proportion of acute hospital attendances across the UK. This increasingly common condition puts pressure on urological services, leading to an increase in time to follow up. BAUS guidelines indicate that for patients managed expectantly, a clinic review should be undertaken within four weeks of presentation. This quality improvement (QI) project reports the benefit of a dedicated virtual colic clinic to facilitate a more efficient care pathway and reduce patient waiting times.
Patients & Methods
The first cycle retrospectively analysed patients referred from the Emergency Department (ED) with uncomplicated acute ureteric colic, excluding those admitted for immediate intervention, over a 2-month period in 2019. A further cycle was carried out 12 months later following the introduction of a new dedicated virtual colic clinic with updated ED referral guidance. QI Methodology was followed throughout with the use of PDSA cycles.
Results
The mean time from referral to clinic review reduced from 7.5 weeks to 3.5 weeks. The percentage of patients who were reviewed in clinic within 4 weeks increased from 25% to 82%. The meant time from referral to intervention, including shockwave lithotripsy and primary ureteroscopy reduced from 15 weeks to 5 weeks.
Conclusion
The introduction of a virtual colic clinic to our service has improved the definitive management of ureteric colic for patients managed expectantly. This has reduced waiting times for both clinic review and stone treatment which has enhanced patient experience. This intervention now adheres to the timeline outlined by current BAUS guidance.
Ureteric colic constitutes a large proportion of acute hospital attendances across the UK. This increasingly common condition puts pressure on urological services, leading to an increase in time to follow up. BAUS guidelines indicate that for patients managed expectantly, a clinic review should be undertaken within four weeks of presentation. This quality improvement (QI) project reports the benefit of a dedicated virtual colic clinic to facilitate a more efficient care pathway and reduce patient waiting times.
Patients & Methods
The first cycle retrospectively analysed patients referred from the Emergency Department (ED) with uncomplicated acute ureteric colic, excluding those admitted for immediate intervention, over a 2-month period in 2019. A further cycle was carried out 12 months later following the introduction of a new dedicated virtual colic clinic with updated ED referral guidance. QI Methodology was followed throughout with the use of PDSA cycles.
Results
The mean time from referral to clinic review reduced from 7.5 weeks to 3.5 weeks. The percentage of patients who were reviewed in clinic within 4 weeks increased from 25% to 82%. The meant time from referral to intervention, including shockwave lithotripsy and primary ureteroscopy reduced from 15 weeks to 5 weeks.
Conclusion
The introduction of a virtual colic clinic to our service has improved the definitive management of ureteric colic for patients managed expectantly. This has reduced waiting times for both clinic review and stone treatment which has enhanced patient experience. This intervention now adheres to the timeline outlined by current BAUS guidance.
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