Skip to main content
PMC home page
Annals of The Royal College of Surgeons of England logoLink to Annals of The Royal College of Surgeons of England
. 1995 Jul;77(4):287–289.

Efficiency in the outpatient department: the lessons from urology.

T S O'Brien 1, J M Perkins 1, D Cranston 1
PMCID: PMC2502341  PMID: 7574322

Abstract

To determine the scope for improvements in efficiency in the outpatient management of urological patients, a retrospective analysis was undertaken of outpatient records from one consultant's practice in a regional teaching hospital. Two hundred consecutive patients referred between March and May 1992 were studied for 1 year after referral. Each outpatient visit was judged to be unavoidable or potentially avoidable. Of referrals, 72% were in one of four diagnostic categories (bladder outflow obstruction; haematuria; scrotal disorders; frequency/dysuria syndromes). Of these patients, 90% were seen only once or twice for each episode of illness. Of the visits, 150/347 (42%) were potentially avoidable. Patients with suspected bladder outflow obstruction, haematuria and scrotal disorders should undergo imaging of the relevant anatomy before referral. Patients with haematuria should be referred directly for a flexible cystoscopy after imaging. Urologists need to educate general practitioners more clearly about the indications for the treatment of scrotal swellings in elderly men and mild bladder outflow obstruction in middle-aged men. Patients need not be reviewed routinely after transurethral resection of the prostate for benign prostatic hypertrophy or after investigations for haematuria have revealed no serious abnormality.

Full text

PDF
289

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Britton J. P. Effectiveness of haematuria clinics. Br J Urol. 1993 Mar;71(3):247–252. doi: 10.1111/j.1464-410x.1993.tb15936.x. [DOI] [PubMed] [Google Scholar]
  2. Cuckow P. M. Cost of urology: financial audit in a clinical department. BMJ. 1992 Sep 26;305(6856):743–746. doi: 10.1136/bmj.305.6856.743. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Doll H. A., Black N. A., McPherson K., Flood A. B., Williams G. B., Smith J. C. Mortality, morbidity and complications following transurethral resection of the prostate for benign prostatic hypertrophy. J Urol. 1992 Jun;147(6):1566–1573. doi: 10.1016/s0022-5347(17)37628-0. [DOI] [PubMed] [Google Scholar]
  4. German K., Nuwahid F., Matthews P., Stephenson T. Dangers of long waiting times for outpatient appointments at a urology clinic. BMJ. 1993 Feb 13;306(6875):429–429. doi: 10.1136/bmj.306.6875.429. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Jones Elwyn G., Stott N. C. Avoidable referrals? Analysis of 170 consecutive referrals to secondary care. BMJ. 1994 Sep 3;309(6954):576–578. doi: 10.1136/bmj.309.6954.576. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Pope C. Waiting times for outpatient appointments. BMJ. 1993 Feb 13;306(6875):408–409. doi: 10.1136/bmj.306.6875.408. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Rao J. N. Follow up by telephone. BMJ. 1994 Dec 10;309(6968):1527–1528. doi: 10.1136/bmj.309.6968.1527. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Wilson N. V., Collins R. E. Surgical outpatient practices--a time for change? Ann R Coll Surg Engl. 1994 Jul;76(4 Suppl):169–171. [PubMed] [Google Scholar]

Articles from Annals of The Royal College of Surgeons of England are provided here courtesy of The Royal College of Surgeons of England

RESOURCES