A new approach to managing follow-up patients with sino-nasal disorders: the rhinology panel

Abstract

Background/aims There is a growing backlog of patients with sino-nasal disorders waiting for a follow-up appointment. This study aimed to identify rhinology patients on the outpatient follow-up list who could be removed from the waiting list for a face to face follow-up appointment and instead either given a phone consultation by a clinical nurse specialist or discharged from the service. Methods The clinical records of patients on the waiting list for a follow-up appointment at a nasal disorders clinic were reviewed by a panel comprising a consultant rhinologist, a rhinology fellow, a specialist registrar and two nurse specialists. Results A total of 300 clinical records of patients on the follow-up list of the Rhinology clinic were identified, of which 253 were found to have a sino-nasal disorder. Of these, 137 patients (54%) were discharged from the rhinology face to face follow-up clinics, while 116 patients (46%) were given face to face review appointments. Conclusions A multi-professional rhinology review panel is an effective way of managing the waiting list of an outpatient rhinology clinic and providing nurse-led telephone consultations could decrease the strain on resources while maintaining patient safety.

A systematic review of outcomes of remote consultation in ENT

“…Three studies reported follow‐up of rhinology patients via phone call and videoconference 20,64,65 . Two of these reported the proportion of patients assessed remotely requiring subsequent F2F consultation at 7.5% (19/253) 20 and 1.5% (5/339), 64 with reasons including need for biopsy and examination. Referral to follow‐up time was shorter with remote consultation—8‐12 weeks compared to 12 weeks on the F2F pathway 20 …”

“…Two studies reported greater patient acceptance of remote consultation over F2F review during the pandemic. 65,67 Looking forward, future research should build upon that suggested by some studies 20,29,36,55 to better define the symptom profiles or patient groups that may be appropriate for remote consultation, particularly for initial consultation. It may be better to perform such studies in selected populations rather than unselected groups.…”

“…Table 2 details patient pathway efficiency outcomes: only six studies reported (or had inferable) data for all five of these outcomes. [20][21][22][23][24][25] Tables 3-5 detail outcomes for user satisfaction, cost analysis and safety.…”

“…Three studies reported follow-up of rhinology patients via phone call and videoconference. 20,64,65 Remote rhinology follow-up was reported at greater than 80% overall user satisfaction in two studies. 64,65 Both studies also reported the most common advantage to remote follow-up was convenience in cost and time compared to F2F review and the most common disadvantage was the lack of physical examination.…”