Consultant-lead telephone follow up clinics - can these save the urology outpatient wait crisis?
BAUS ePoster online library. Lodhia S. Jun 25, 2019; 259489; P12-5
Dr. Siya Lodhia
Dr. Siya Lodhia
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Introduction: To address a chronic outpatient follow-up backlog, we ran Consultant-lead telephone clinics at our District General Hospital for 4months.
Unscreened patients were phoned by our secretaries and offered one hour time slots in day or evening clinics. Four hour clinics were built with 5 patients/hour. Two unanswered calls constituted a DNA. Each Consultant audited at least 1 clinic. Subsequently patients were contacted for feedback.
114 interactions were audited. 89% of patients answered. Mean call duration was 6.5 minutes (range 2-21) and mean overall time per case was 13.4 minutes (range 4-49) allowing for notes reading, booking tests, prescribing, dictation and data input). 13% of patients required a face-to-face assessment. Half were discharged, a third given further follow-up, 8% booked for theatre. 7% sent a hospital prescription and 29% had tests booked. The physical hospital notes were helpful in 42%.
51 patients gave feedback. 100% felt their consultation was the right length and 97% had all questions addressed. 80% were satisfied/very satisfied. Patients slightly preferred telephone consults to hospital appointments (48% vs 38%).
No patient safety issues have emerged from decisions made in these patients.
Though this unselected group were satisfied, we did not realize the efficiencies we had anticipated. Consults were no quicker, DNAs were high despite agreed time-slots, 13% had a futile interaction and notes still had to be pulled. Pre-operative consenting was not possible.
Telephone clinics are acceptable, safe and environmentally friendly. We intend to reopen these in the future only for selected patients
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