Clinical audit of a specialist symptomatic breast clinic.
The efficient delivery of health care requires vigilant quality assurance. We describe the audit of our symptomatic breast clinic, which includes the option of a one-stop diagnostic service. A total of 134 new and 386 follow-up patients attended over four consecutive clinics. The majority of new referrals (68%) were seen by a consultant surgeon. Urgent referrals were seen significantly sooner than routine referrals (P < 0.001, chi 2-test), and the mean wait from designated appointment to seeing the surgeon was 37.6 (range-68 to 171) min. One-stop investigations were offered to 50 patients; of these, 36 women (72%) had a total wait of less than 2 h. For those not investigated at the same clinic, the mean time until investigations was 6.1 (range 0-36) days and mean recall was 2.7 (range 1-8) weeks. Patients undergoing definitive surgery for cancer (n = 5) were operated on average 14.2 (range 7-27) days after the decision was made in outpatients, while the mean waiting time for non-cancer operations was 49.7 (range 15-98) days. Objective audit on outpatient services is possible and can lead to improvement of services.
Gui
G P
GP
Breast Unit, St Bartholomew's Hospital, West Smithfield, London, UK.
Allum
W H
WH
Perry
N M
NM
Wells
C A
CA
Curling
O M
OM
McLean
A
A
Oommen
R
R
Sullivan
M
M
Denton
S
S
Carpenter
R
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001071:Appointments and Schedules; D001941:Breast Diseases / Q000175:diagnosis*; D002985:Clinical Protocols / Q000592:standards; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008131:London; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration / Q000592:standards / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012017:Referral and Consultation; D013997:Time Factors; D014600:Utilization Review; D014850:Waiting Lists