Urogynecology triage clinic: a model of healthcare delivery
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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.
The case notes of 300 patients attending the UTC in a university hospital between January 2006 and November 2007 were randomly selected for review.
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.
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.
KeywordsTriage clinic Urogynecology
Conflicts of interest
- 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.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
- 5.Roy S (1997) Royal College of Nursing Continence Care Forum. The cost of incontinence. Briefing paper no. 000 809. RCN, LondonGoogle Scholar
- 6.Pollock D (1998) Towards a service of the highest quality: evidence to the NHS review of continence services. Continence Foundation, LondonGoogle Scholar
- 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.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.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
- 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.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.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
- 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