Outpatient follow up appointments; are we using the resources effectively?
OBJECTIVE
British Association of Urological Surgeons (BAUS) guidelines and government initiatives have put pressure on the effective use of outpatient resources. Follow up appointments need to be carefully managed to ensure efficient use of available resources. The aim of this study was to audit outpatient follow up service with particular attention to the appropriateness of the appointments made.


METHODS
All patients attending a general urology clinic were assessed by a form completed for each individual appointment. The source of the appointment and the time interval was recorded and each follow up appointment was judged to be either appropriate or inappropriate by the person giving the consultation. For those deemed to be inappropriate, justification was sought and the notes independently reviewed by a different clinician to verify this categorisation.


RESULTS
Of 164 appointments made, 143 patients attended for follow up. A total of 131 appointments were considered to be appropriate (92%) with only 12 deemed by the consulting clinician to be inappropriate (8%). The commonest cause for an inappropriate appointment was failure to appreciate that follow up had already been arranged for a different date. There was no correlation between the source of the referral and an inappropriate referral.


CONCLUSIONS
This audit suggests an effective use of the outpatient follow up resource with respect to the appropriateness and timing of follow up consultations. Other areas of resource management such as default rates should be investigated in an attempt to improve the efficiency of a service.
Bromage
S J
SJ
Department of Urology, Manchester Royal Infirmary, Manchester, UK. sjbromage@doctors.org.uk
Napier-Hemy
R D
RD
Payne
S R
SR
Pearce
I
I
D000553:Ambulatory Care / Q000706:statistics & numerical data*; D001071:Appointments and Schedules; D004739:England; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D008485:Medical Audit; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*; D012017:Referral and Consultation