International Urogynecology Journal

, Volume 20, Issue 8, pp 913–917 | Cite as

Urogynecology triage clinic: a model of healthcare delivery

  • Reeba Oliver
  • Ranee Thakar
  • Abdul H. Sultan
  • Anne Phillimore
Original Article

Abstract

Introduction and hypothesis

To establish whether a nurse-led urogynecology triage clinic (UTC) is effective in terms of patient journey (from primary referral to first hospital contact until discharge), diagnosis, management, and outcomes.

Methods

The case notes of 300 patients attending the UTC in a university hospital between January 2006 and November 2007 were randomly selected for review.

Results

The mean interval from referral to first visit improved from 15.6 weeks (range = 12–32 weeks) to 4.6 weeks (range = 1–11 weeks, SD = 1.97) after UTC. Compared to pre-UTC, the mean period from first visit to final outcome improved from 11 months (range = 3.0–23.0 months) to 8.8 weeks (range = <1–60 weeks, SD = 11.15). Fifty-nine percent were discharged from the UTC without being seen by a specialist.

Conclusions

By service redesigning, the UTC has reduced the number of clinic visits and patient journey time and has also shown that the majority of women with incontinence can be adequately managed by a specialist nurse.

Keywords

Triage clinic Urogynecology 

References

  1. 1.
    Department of Health (2001) National service framework for older people. DH, London. Available at http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4003066
  2. 2.
    Perry S, Shaw C, Assassa P, Dallosso H, Williams K, Brittain KR et al (2000) An epidemiological study to establish the prevalence of urinary symptoms and felt need in the community: the Leicestershire MRC Incontinence Study. Leicestershire MRC Incontinence Study Team. J Public Health Med 22:427–434PubMedCrossRefGoogle Scholar
  3. 3.
    Minassian VA, Stewart WF, Wood GC (2008) Urinary incontinence in women: variation in prevalence estimates and risk factors. Obstet Gynecol 111:324–331PubMedGoogle Scholar
  4. 4.
    Roe B, Doll H (2000) Prevalence of urinary incontinence and its relationship with health status. J Clin Nurs 9:178–187PubMedCrossRefGoogle Scholar
  5. 5.
    Roy S (1997) Royal College of Nursing Continence Care Forum. The cost of incontinence. Briefing paper no. 000 809. RCN, LondonGoogle Scholar
  6. 6.
    Pollock D (1998) Towards a service of the highest quality: evidence to the NHS review of continence services. Continence Foundation, LondonGoogle Scholar
  7. 7.
    Department of Health (2004) The National Health Service Improvement Plan: putting people at the heart of public services. Available at http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4084476
  8. 8.
    Department of Health (2000) Good practice in continence services. DH, London. Available at http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4005851
  9. 9.
    Department of Health (2008) NHS next stage review: our vision for primary and community care. Available at http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_085937
  10. 10.
    Abu J, Habiba M, Baker R, Halligan AWF, Naftalin NJ, Hsu R et al (2001) Quantitative and qualitative assessment of women's experience of a one-stop menstrual clinic in comparison with traditional gynaecology clinics. BJOG 108:993–999PubMedCrossRefGoogle Scholar
  11. 11.
    Thomas RE, Grimshaw JM, Mollison J, McClinton S, McIntosh E, Deans H et al (2003) Cluster randomized trial of a guideline-based open access urological investigation service. Fam Pract 20:646–654PubMedCrossRefGoogle Scholar
  12. 12.
    McGhee M, O'Neill K, Major K, Twaddle S (1997) Evaluation of nurse-led continence services in the south west of Glasgow, Scotland. J Adv Nurs 26:723–728PubMedCrossRefGoogle Scholar
  13. 13.
    Department of Health (2001) Standing Nursing and Midwifery Advisory Committee. Caring for older people: a nursing priority. integrating knowledge, practice and values. The Stationery Office, LondonGoogle Scholar
  14. 14.
    National Collaborating Centre for Women's and Children's Health and the National Institute for Health and Clinical Excellence (2006) Urinary incontinence: the management of urinary incontinence in women. CG40. RCOG Press, London. Available at http://www.nice.org.uk/guidance/index.jsp?action=download&o=30281
  15. 15.
    Holtedahl K, Verelst M, Schiefloe A, Hunskaar S (1999) Usefulness of urodynamic examination in female urinary incontinence. Scand J Urol Nephrol 34:169–174Google Scholar
  16. 16.
    Seim A, Sivertsen B, Eriksen B, Hunskaar S (1996) Treatment of urinary incontinence in women in general practice: observational study. BMJ 312:1459–1462PubMedGoogle Scholar
  17. 17.
    Department of Health (2006) Our health, our care, our say: a new direction for community services. DH, London. Available at http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4127453

Copyright information

© The International Urogynecological Association 2009

Authors and Affiliations

  • Reeba Oliver
    • 1
  • Ranee Thakar
    • 1
  • Abdul H. Sultan
    • 1
  • Anne Phillimore
    • 1
  1. 1.Mayday University HospitalCroydonUK

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