The "acute" Stone Clinic Effect: Improving Healthcare Delivery by Reorganizing Clinical Resources

Mark A. Assmus, Shubha De, Trevor D. Schuler, Derek Bochinski, Timothy A. Wollin*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1096-1100
Number of pages5
JournalJournal of Endourology
Volume31
Issue number10
DOIs
StatePublished - Oct 2017
Externally publishedYes

Keywords

  • quality improvement
  • resource management
  • stone disease

ASJC Scopus subject areas

  • Urology

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