Introduction With the demand for patient choice and increasing numbers of outpatients being reviewed in secondary care, a nurse led telephone clinic has proved to be an important part of patients care1. Our clinic was first developed in 2009 as a way of providing more efficient follow up care to our patients post procedure.
The Aim of this study was to identify and analyse the current use of our telephone clinic and the type of patients and conditions that are managed by the nursing team.
Methods A retrospective study of all patients enrolled between May 2009 and November 2012 to the telephone clinic (TC) was completed. Demographics, procedure referral reason, attendance and outcome data were analysed. This was compared with our current face to face outpatients (FTFOP) data. Costs of care were estimated using data sourced from NHS tariff 2011–12.
Results There were 1021 individual appointments made of which 807 (79%) appointments were completed, 57 messages were left and 82 patients were unable to be contacted. FTFOP non attendance rate was 28% vs 20% for the telephone clinic. 54.3% of patients were female vs 63.7% in FTFOP. The majority of patienits, (85%) were called with the primary reason of test results. 5.6% of patients were contacted with the primary objective of review and advice.
Patients problems were seperated where possible into catagories 3.4% hepatobiliary, 5.8% indeterminate, 42% Lower Gastrointestinal (GI), 49% upper GI. Particular common complaints being addressed included dyspepsia, 19.4% of total patient referral reasons and 7.4% change in bowel habit. 77% of patients were discharged after the telephone consultation with 3.3% given an open appointment. 9.3% required specific timed follow up in FTFOP. With current tariffs for non face to face out patient appointments at £55.15 vs FTFOP of £141.44 we expect initial annual savings based on an average of 235 consultations a year of £20,278.15.
Conclusion The telephone clinic has provided a useful adjunct in patient to provider care. The data haves shown that a variety of conditions can be successfully managed and relatively few patients require subsequent follow up in a face to face consultation. The clinic seems to be particularly useful in dealing with clinical symptoms which have algorithmic management, such as dyspepsia. Non-attendance rates were comparable. Patients have anecdotally liked the service for its efficiency and time saving approach. Development of this service will include increased monitoring of patient symptoms as a primary reason for review and integration to the email helpline service established since 2008.
Disclosure of Interest None Declared.
Impact of a nurse-led telephone clinic on quality of IBD care Sharon Gethins et al. Gastrointestinal Nursing, Vol. 5, Iss. 1, 18 Jan 2007, pp 34 – 39