We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Changing the routine: a move to patient initiated follow up to improve surgical outpatient clinic.
- Authors
Balhorn, Joshua; Su'a, Bruce; Jin, James; Peng, Sze‐Lin; Weston, Maree; Israel, Lincoln; Connolly, Andrew; Hill, Andrew G.; Taneja, Ashish
- Abstract
Introduction: Patient initiated follow up (PIFU) allows patients to initiate a hospital follow up appointment on an 'as required' basis in contrast to the traditional physician‐initiated model. We present a clinical pathway for patients referred with rectal bleeding at a large tertiary public hospital in South Auckland, New Zealand and demonstrate the utility of PIFU and its impact on reducing follow up appointments. Method: The purpose of the pathway was to allow standardized care by the clinicians and allow for PIFU. Two separate protocols were developed ‐ 'Painful PR bleeding' and 'Painless PR bleeding'. A new clinic (NC) was started following these protocols, and this was compared to historical controls (HC). The primary outcome was the rate of follow up appointments. Results: There were 133 patients in the NC and 135 in the HC, with significantly less follow ups in the NC (6% versus 45%, p < 0.0001). A small percentage of patients in the NC group were directly discharged (10%) whilst 70% of patients were discharged with a PIFU card. Thirty phone calls were made using PIFU, with 10 patients returning to clinic and 20 requiring advice and reassurance only. At 5 year follow up, there was a single colorectal malignancy found in both groups. Conclusion: Initiating a protocol that includes patient initiated follow up vastly reduces the need for routine return to clinic for the majority of patients, without sacrificing patient care. A protocolised approach to clinic for other areas in general surgery should be considered.
- Subjects
AUCKLAND (N.Z.); SURGICAL clinics; PUBLIC hospitals; HOSPITAL patients; TELEPHONE calls; HOSPITAL admission &; discharge; AMBULATORY surgery
- Publication
ANZ Journal of Surgery, 2022, Vol 92, Issue 6, p1394
- ISSN
1445-1433
- Publication type
Article
- DOI
10.1111/ans.17676