Outpatient follow up appointments; Are we using the resources effectively?

Bromage, Stephen J.; Napier-Hemy, Richard; Payne, S. R.; Pearce, Ian

doi:10.1136/pgmj.2005.043547

Cited by 9 publications

(4 citation statements)

References 4 publications

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“…Several studies have tried to identify areas for improvement. In one study, follow-up appointments appeared appropriate in 92% of cases leaving little room for improvement [16]. Other studies have tried to address the non-attendance rate.…”

Section: Discussionmentioning

confidence: 99%

National Re-Audit of Urology Outpatient Practice in UK

Sinclair

Derbyshire

Clarke

et al. 2009

British Journal of Medical and Surgical Urology

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Introduction: In 2002 a National structure audit was conducted to assess UK urologists' compliance with BAUS guidelines on outpatient provision. Given the recent change in government emphasis on waiting targets, and the possible impact of MMC and EWTD on trainees, we re-audited the contemporary urological clinic-based workload and service provision. Methods: All 649 UK consultant urologists were asked to complete a postal questionnaire. This provided outpatient clinic information on medical staff, clinic frequency, numbers of new and follow-up patients seen, and geographical region. Data was compared to 2002. Results: Usable questionnaire return rate was 65%. Median clinics/week were 1.87 (1-5) seeing a mean of 11.2 (1-32) new and 21.5 (1-80) follow-ups. Since 2002 consultant appointments have increased by 20%, SpR clinic attendance has decreased by 10%, with 'consultant-only' clinics increasing from 15% to 20.7%. Compliance with BAUS standards remains very low (18% vs. 21% ( 2002)) with the average consultant team 'over-performing' by a factor of 1.4. There were wide inter-and intra-regional variations. Conclusion: Despite growth in consultant numbers since 2002, very few urological teams are able to meet the BAUS clinic guidelines. A trend has been demonstrated in clinic towards a consultant-led service with less support from doctors-in-training.

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Section: Discussionmentioning

confidence: 99%

National Re-Audit of Urology Outpatient Practice in UK

Sinclair

Derbyshire

Clarke

et al. 2009

British Journal of Medical and Surgical Urology

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“…Outpatient clinic resources are increasingly demanding and require more effective usage. Bromage et al studied the urology outpatient follow-up visits and concluded appropriateness and timing of outpatient follow-ups is necessary for more efficient usage of outpatient follow-up recourses [13]. Alternatives for post-operative follow-ups for benign pathology results are being explored to create more time for outpatient clinic visits for new patients.…”

Section: More Efficient Post-operative Follow-ups In Other Surgical Smentioning

confidence: 99%

Need for post-operative outpatient appointments after discharge following cervical spinal surgery - a narrative review

Bree

Atsma

Lindert

et al. 2020

BMC Musculoskelet Disord

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Background In the Netherlands most patients are currently seen in an outpatient clinic after an anterior cervical discectomy, which is an effective neurosurgical procedure with relatively low rate of severe complications. In this back sight, the need for patients returning to the post-operative outpatient clinic could be questioned. The aim of the study is to evaluate whether a post-operative outpatient appointment after anterior cervical discectomy could be replaced by an alternative or be omitted without adversely impacting, or increasing, the value of healthcare and patient satisfaction for this procedure. Methods A narrative review was performed to evaluate the quality of care and patient satisfaction for patients with and without a post-operative outpatient appointment after spinal surgery. A literature search of the previous ten years was performed in Pubmed, CENTRAL and EMBASE. Results A total of 403 articles were identified. Four studies remained after title and abstract selection by 3 independent reviewers. No papers were selected for further analysis, due to the absence of interventional studies that compared the utility of a post-operative outpatient clinic appointment with an intervention after spinal surgery. Conclusions Currently, there is a lack of evidence for the need of a post-operative follow-up after anterior cervical discectomy. Nor is there any literature in favor of omitting these appointments. No determinants which patients benefits from these outpatient appointments could be identified. Potential harmful and beneficial effects of omitting these post-operative follow-ups should be investigated to identify possible determinant for patients who might benefit from a post-operative appointment.

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“…Telephone consultations may also allow valuable outpatient clinic time to be occupied by those patients who have a more severe or complex conditions. This form of follow-up might also help improve compliance with scheduled follow-ups, avert the need for health care professionals to provide home visits, and prevent unnecessary return visits to the emergency department [3,14]. …”

Section: Introductionmentioning

confidence: 99%

Telephone consultations in place of face to face out-patient consultations for patients discharged from hospital following surgery: a systematic review

Thompson‐Coon

Abdul-Rahman

Whear

et al. 2013

BMC Health Serv Res

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BackgroundRoutine follow-up following uncomplicated surgery is being delivered by telephone in some settings. Telephone consultations may be preferable to patients and improve outpatient resource use. We aimed to compare the effectiveness of telephone consultations with face to face follow-up consultations, in patients discharged from hospital following surgery.MethodsSeven electronic databases (including Medline, Embase and PsycINFO) were searched from inception to July 2011. Comparative studies of any design in which routine follow-up via telephone was compared with face to face consultation in patients discharged from hospital after surgery were included. Study selection, data extraction and quality appraisal were performed independently by two reviewers with consensus reached by discussion and involvement of a third reviewer where necessary.ResultsFive papers (four studies; 865 adults) met the inclusion criteria. The studies were of low methodological quality and reported dissimilar outcomes precluding any formal synthesis.ConclusionsThere has been very little comparative evaluation of different methods of routine follow-up care in patients discharged from hospital following surgery. Further work is needed to establish a role for telephone consultation in this patient group.

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Outpatient follow up appointments; Are we using the resources effectively?

Abstract: This audit suggests an effective use of the outpatient follow up resource with respect to the appropriateness and timing of follow up consultations. Other areas of resource management such as default rates should be investigated in an attempt to improve the efficiency of a service.

Cited by 9 publications

References 4 publications

National Re-Audit of Urology Outpatient Practice in UK

National Re-Audit of Urology Outpatient Practice in UK

Need for post-operative outpatient appointments after discharge following cervical spinal surgery - a narrative review

Telephone consultations in place of face to face out-patient consultations for patients discharged from hospital following surgery: a systematic review

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