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A prospective audit of emergency urology activity in a university teaching hospital

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Abstract

Introduction

Urology cover is commonly available out-of-hours in most teaching hospitals. However, increased pressure to reduce hospital expenditure has forced many institutions to consider removing middle grade cover outside of normal working hours. The aim of this study was to audit the emergency urology activity in our institution over a 12-month period.

Methods

A prospective logbook was maintained for all urology referrals from the emergency department between August 2012 and March 2013. The diagnosis and patient outcome was recorded for each referral. The emergency theatre logbook was retrospectively evaluated for all emergency urology procedures carried out over the same time period. A basic cost analysis was performed to calculate the cost of providing the on-call service.

Results

A total of 752 patients were referred to the urology service over a 12-month period. The most common reasons for referral were renal colic and scrotal pain. Approximately 41 % of referrals were discharged directly from the emergency department. There were 167 emergency operations performed in total. The majority of emergency operations and referrals from the emergency department took place outside of normal working hours. A basic cost analysis revealed an associated cost saving of €58,120.

Conclusion

Emergency urology activity constitutes a large proportion of the workload at our institution. Restricting emergency urology cover would limit essential training opportunities for urology trainees, increases length of stay and delay treatment of urological emergencies. Urology “out of hours” cover is a cost-efficient method of service provision.

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References

  1. The Royal College of Surgeons of Ireland. New Surgical Training Pathway. 2012. Available online: http://www.rcsi.ie/aboutsurgicaltrainingpathway. Accessed on: 22/11/13

  2. The Royal College of Surgeons of England. Developing a Modern Surgical Workforce. 2005. Available online: www.rcseng.ac.uk/services/publications/publications/index_html?pub_id=177. Accessed on: 22/11/13

  3. (1993) European Council Directive 93/104/EC. Official J Eur Commun. L307: 18–24

  4. Benes V (2006) The European working time directive and the effects on training of surgical specialists (doctors in training). Acta Neurochir (Wien) 148(9):1020–1026

    Article  Google Scholar 

  5. Breen KJ, Hogan AM, Mealy K (2013) The detrimental impact of the implementation of the European working time directive (EWTD) on surgical senior house officer (SHO) operative experience. Ir J Med Sci 182(3):383–387

    Article  CAS  PubMed  Google Scholar 

  6. Bates T, Slade D (2007) The impact of the European working time directive on operative exposure. Ann R Coll Surg Engl 89(4):452

    Article  PubMed Central  Google Scholar 

  7. Stephens MR, Pellard S, Boyce J et al (2004) Influence of EWTD-compliant rotas on SHO operative experience. Ann R Coll Surg Engl 86:120–121

    Article  Google Scholar 

  8. Thiruchelvam N, Adamson A (2006) Competency and training of general surgery specialist registrars in emergency urology. BJU Int 98(1):6–7

    Article  PubMed  Google Scholar 

  9. Central Statistics Office, Cork, Ireland. CD102: Actual and percentage change in population by Province or County, CensusYear and Statistic. Available online at: [http://www.cso.ie] Accessed: 20/11/2013

  10. Health Service Executive. Contract of employment for Non-consultant hospital doctors. Available online at: [www.medicine.tcd.ie/assets/doc/NCHD-Contract.doc]. Accessed: 20/11/13

  11. Health Service Executive. Hospital charges. Available online: [http://www.hse.ie/eng/services/list/3/hospitals/Hospitalcharges.html]. Accessed: 20/11/13

  12. Health Services Executive. Admissions and discharges guidelines. Available online at: http://www.dohc.ie/issues/health_strategy/action84.pdf?direct=1. Accessed on: 20/11/13

  13. NHS England. High quality care for all, now and for future generations: Transforming urgent and emergency care services in England. The Evidence Base from the Urgent and Emergency Care Review. Available online at: [http://www.england.nhs.uk/wp-content/uploads/2013/06/urg-emerg-care-ev-bse.pdf]. Accessed on: 20/11/13

  14. Nagree Y et al (2013) Quantifying the proportion of general practice and low-acuity patients in the emergency department. Med J Aust 198(11):612–615

    Article  PubMed  Google Scholar 

  15. Hellawell GO, Kahn L, Mumtaz F (2005) The European working time directive: implications for subspecialty acute care. Int J Clin Pract 59(5):508–510

    Article  CAS  PubMed  Google Scholar 

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Conflict of interest

Ms. Redmond has nothing to disclose.

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Correspondence to E. J. Redmond.

Additional information

This work received the ISU Registrar’s Prize when presented at the Irish Society of Urology annual meeting in September 2013.

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J. Redmond, E., Forde, J.C., Abdelrahman, M.A. et al. A prospective audit of emergency urology activity in a university teaching hospital. Ir J Med Sci 184, 493–497 (2015). https://doi.org/10.1007/s11845-014-1154-8

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  • DOI: https://doi.org/10.1007/s11845-014-1154-8

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