WCE 2019: A Novel One-Stop LUTS Clinic Model from a Tertiary Referral University Hospital in the United Kingdom
Abu Dhabi, United Arab Emirates (UAE) (UroToday.com) Uma Walters, a CT1 Doctor at Charing Cross Hospital - Imperial College Healthcare NHS Trust, presented their experience with a new “one-stop” lower urinary tract clinic to improve the efficiency of evaluation, diagnosis, and treatment. In their current model, patients wait an average of 20 weeks to be seen and 55 weeks for the subsequent follow-up (often for ancillary diagnostic procedures) prior to ultimate treatment. The one-stop clinic included the consultation as well as any required diagnostic tests (flow rate, post- voiding bladder scan, flexible cystoscopies, urodynamic studies, and/or transrectal ultrasound scans) on the same day. The traditional pathway (298 patients) was compared with the new pathway (109 patients) in a retrospective fashion. The one-stop clinic pathway reduced the need for follow-up appointments from 60% (current) to 5% (one-stop). Furthermore, they noted an increase in patients offered surgical management at the initial visit (from 10% in current to 57% in one-stop). There was also an increase in discharge from the clinic from 25% to 32%. They also noted that pre-appointment calls to patients decreased the rate of Did Not Attend (DNA) or no-show appointments from 19% to 2%. They found that the patients highly preferred the one-stop clinic (98%) and 100% reported feeling satisfied.
The implementation of this new one-stop clinic in their healthcare system reduced the waiting time by 35 weeks, while providing more consistent, higher quality of care with quicker diagnoses and shorter time to surgical treatment. Vetting and calling patients prior to clinic reduced the no show rate and optimized appointment utilization. There was high satisfaction of both patients and staff.
Presented by: Uma Walters, MBBS, BSc, MRCS, Core Surgical Trainee, Charing Cross Hospital - Imperial College Healthcare NHS Trust, London, England
Co-Authors: Tara Latimer, MBBS, GPEP, Sophie Dean, Michael Morgan, MBBS, Viren Jeram, Tamer El-Husseiny, MBBCh, MSc, MRCS, MD, FEBU, FRCS
Written by: Pengbo Jiang, MD, Department of Urology, University of California, Irvine, Medical Writer for UroToday.com at the 37th World Congress of Endourology (WCE) – October 29th-November 2nd, Abu Dhabi, United Arab Emirates