Biomedical subjects
Celia Ingham Clark
Publications and source records attributed to Celia Ingham Clark.
An effective electronic surgical referral system.
INTRODUCTION: Electronic booking of out-patient appointments is being rolled out in England under the 'Choose and Book' programme. We set up and ran a local electronic surgical referral service before this. This paper assesses the effect of the electronic surgical referral service on patient waiting times and attendance rates. PATIENTS AND METHODS: The study included 54 patients referred electronically and 189 referred on paper to a single colorectal surgical service over the same period. RESULTS: The appointment booking was achieved on the same day as the referral was made for the majority of electronic referrals whereas it took an average of 7 days for paper referrals. There was no significant difference in the time from referral to being seen in clinic between the two groups. Patients referred electronically were much more likely to attend for their appointment. CONCLUSIONS: This study shows that an electronic surgical referral system can improve efficiency. This may be because this system allows enhanced patient choice of appointment date and time.
Which patients would prefer to walk to theatre?
INTRODUCTION: Increasing patient autonomy in the pre-operative period may help to lessen the anxiety associated with under-going a surgical procedure, and may enhance patient satisfaction. This study seeks to explore patients' preferences for mode of travel to the operating theatre. PATIENTS AND METHODS: A questionnaire survey was undertaken with all patients having an in-patient or day-case surgical procedure over a 4-week period at one hospital. Results were analysed with respect to the patients' age, gender and surgical specialty. RESULTS: In all, 171 patients completed the questionnaire, 118 day-cases and 53 in-patients. In both sexes and in all age groups, the majority of patients expressed a preference to walk to theatre. The only sub-group which demonstrated an equal preference for a trolley transfer compared with walking were gynaecology patients. CONCLUSIONS: These results suggest that a high proportion of patients would prefer to walk to theatre for their operation if given the choice. If the policy of offering choice were adopted, it would enhance patient autonomy and may reduce delays in transferring patients to theatre. It may also release portering resources for other purposes.
Influence of a nurse practitioner on non-attendance rate for barium enema.
Non-attendance for barium enema investigation wastes resources, prolongs waiting times and delays diagnosis of colorectal carcinoma. In an inner-city hospital with a previous non-attendance rate of over 20% for barium enema we investigated the value of systematic personal contact with a nurse practitioner at the time of booking. We compared two groups of patients, all of whom received an explanation of the procedure from the referring clinician. Patients referred from the colorectal clinic were accompanied by the colorectal nurse practitioner to the radiology department for booking, an appointment being sent later by mail. The nurse practitioner reiterated the details of the procedure, provided supplementary information, confirmed the patient's contact details and provided a telephone number in case further information or assistance was needed. Patients referred from the gastroenterology clinic were managed as previously, making their own way to the radiology department and receiving supplementary information only on request. The patients referred from the two clinics were closely similar; however, the non-attendance rate for the intervention (colorectal) clinic was 4/157 (2.5%) compared with 17/110 (15.5%) for the comparison clinic (P<0.001). A year previously the non-attendance rates in these clinics had been 23% and 20%, respectively. These results indicate that personal contact, with supplementary information, can substantially reduce the non-attendance rate for barium enema.