TY - JOUR
T1 - The "acute" Stone Clinic Effect
T2 - Improving Healthcare Delivery by Reorganizing Clinical Resources
AU - Assmus, Mark A.
AU - De, Shubha
AU - Schuler, Trevor D.
AU - Bochinski, Derek
AU - Wollin, Timothy A.
N1 - Funding Information:
No competing financial interests exist for M.A.A., S.D., T.D.S., and T.A.W. Dr. Bochinski reports nonfinancial support from Sanofi, nonfinancial support from Boston Scientific, nonfinancial support from Eli Lilly, and nonfinancial support from Mylan, outside the submitted work.
Publisher Copyright:
© Copyright 2017, Mary Ann Liebert, Inc. 2017.
PY - 2017/10
Y1 - 2017/10
N2 - Objective: To determine the time to specialist urologic consultation and definitive management after establishing a subspecialist administered acute stone clinic (ASC) for adults with symptomatic upper tract stones in a publically funded universal healthcare system. Materials and Methods: We retrospectively reviewed 337 adult referrals for stone management. Three distinct 9-week periods were assessed. Group 1 patients were seen/treated by their individual urologist before inception of a general urology emergency clinic (pre-EC). Group 2 patients were seen in a pooled EC and Group 3 patients were seen in the ASC. Results: A total of 337 patients (75, pre-EC; 91, EC; 171, ASC) were reviewed. Mean time to consultation for pre-EC, EC, and ASC cohorts was 29, 7, and 7 days respectively (p < 0.05), whereas loss to follow-up decreased from 13% to 5% (p < 0.05). On average, the number of patients seen per week increased from 9 to 20. Mean time to stone surgery from date of referral was 75 days pre-EC, 43 days EC, and 25 days ASC (p < 0.05). The percentage of patients undergoing surgery was between 59% and 63% per cohort; however, the number of patients increased from 5 to 11 per week. Conclusions: By reorganizing clinical resources, a dedicated ASC was able to increase patient capacity, reduce time to urologist consultation and reduce surgical wait times.
AB - Objective: To determine the time to specialist urologic consultation and definitive management after establishing a subspecialist administered acute stone clinic (ASC) for adults with symptomatic upper tract stones in a publically funded universal healthcare system. Materials and Methods: We retrospectively reviewed 337 adult referrals for stone management. Three distinct 9-week periods were assessed. Group 1 patients were seen/treated by their individual urologist before inception of a general urology emergency clinic (pre-EC). Group 2 patients were seen in a pooled EC and Group 3 patients were seen in the ASC. Results: A total of 337 patients (75, pre-EC; 91, EC; 171, ASC) were reviewed. Mean time to consultation for pre-EC, EC, and ASC cohorts was 29, 7, and 7 days respectively (p < 0.05), whereas loss to follow-up decreased from 13% to 5% (p < 0.05). On average, the number of patients seen per week increased from 9 to 20. Mean time to stone surgery from date of referral was 75 days pre-EC, 43 days EC, and 25 days ASC (p < 0.05). The percentage of patients undergoing surgery was between 59% and 63% per cohort; however, the number of patients increased from 5 to 11 per week. Conclusions: By reorganizing clinical resources, a dedicated ASC was able to increase patient capacity, reduce time to urologist consultation and reduce surgical wait times.
KW - quality improvement
KW - resource management
KW - stone disease
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U2 - 10.1089/end.2017.0332
DO - 10.1089/end.2017.0332
M3 - Article
C2 - 28766958
AN - SCOPUS:85031777107
SN - 0892-7790
VL - 31
SP - 1096
EP - 1100
JO - Journal of Endourology
JF - Journal of Endourology
IS - 10
ER -