Ward 5A continue with their Urology
Ambulatory Clinic
The Urology Ambulatory Clinic was started in 2015 with the initial objective to provide recorded
episodes for those patients who had been 'ward attenders'. Through hard work, dedication and
exceptional team work it has grown over the past 3 years.
The development of the clinic now aims to facilitate the early discharge of urology inpatients, to
provide rapid access for specific urology complaints and reduce the waiting time for post-surgical
review. It has allowed the provision of excellent care for urology patients despite increasing demands
on the service, with potential savings that could total £112,000 in 12 months.
Collaboratively adapted service by seeking opportunities to innovate and
improve
Two ward-based clinics began each week on Ward 7, Ulster Hospital in 2015, staffed by a urology
specialty doctor and supported by the nursing team with the aim to create a NEW assessment and
review process for specific urology patients/problems. The opportunity came about as the number of
ward attenders increased and the pressure on inpatient beds soared.
When it was clear that this mode of review was very effective for those patients who would previously
be ad hoc ward attenders, we began to look at our inpatient flow and improve on length of stay by
using the clinic as follow-up support. Having patients often return for Xray appointments, we used
this opportunity to link our Ambulatory Clinic running on Tuesday and Friday mornings with the
Interventional Radiology Service.
Nursing and secretarial staff were inundated with clinical queries from patients already known to
urology and although some could be safely redirected, others needed access to Urology. Instead
of these patients re-attending their GP or presenting to the Emergency Department, we were able
to provide a new access route to urology assessment, often combined with treatment, in order to
relieve pressure on these other overworked services.
Long-term patients in the community (via GP/district nurse/secretary) with urgent queries not suited to
the Emergency Department could then be triaged to ambulatory care. It is here that directed care for
specific problems could be delivered and allow better patient and doctor satisfaction. Now based on
Ward 5A in the Inpatient Ward Block our aim is provide a safe, cost-effective, efficient and specialised
service.
Operated within the finance allocated and demonstrated value for money
Good working relationships have allowed us to provide exceptional care to Urology patients in the
Ambulatory Outpatient setting. By choosing the location within the inpatient ward, it meant that
resources that were being used for inpatients could be flexible in helping our ambulatory patients.
Team work and communication have been vital in sustaining excellent care for our patients, and
these relationships built between Urology, Radiology and the inpatient nursing staff have allowed the
clinic to grow without any extra financial cost.
Inpatient stays for major stone and reconstructive surgery could be reduced from 3 - 4 days to an
overnight stay, where a safety net was put in place by way of the ward's contact details and an
Ambulatory Clinic appointment within days. On data collected over 10 months we could estimate a
saving of 92 bed days per year, which can equate to £48,300 savings for the Trust.
Surgery 40