title: Provision of a "same-day" ultrasound service in an inner-city NHS trust: report on experience and lessons learned after the first 2 years.
abstract: OBJECTIVE
  To assess the effect of changing from an "appointment" to a "same-day" ultrasound (US) service on referral pattern, departmental workload, and patient satisfaction.
  
  
  METHODS
  To reduce US waiting time of 3 weeks for routine examinations, a "same-day" service was started for outpatients and general practitioner (GP) patients in September 2006. To examine the effect of this change a retrospective assessment was performed of workload during 1 week in June 2006 (appointments only) and the same week in 2008, 22 months after the implementation of the new service. Distance travelled by patients and waiting time was recorded. Patient satisfaction with the service was assessed by questionnaire in September 2008.
  
  
  RESULTS
  Hospital referrals remained stable, but GP referrals increased from 99 to 367 (270%) and distance travelled by patients increased from a median of 3.1 km (range 0.1-12.1 km) in 2006 to 4.8 km (range 0.2-19.8 km) in 2008 (p<0.001). Non-local GP referrals increased from 20/99 in 2006 (20%) to 198/367 in 2008 (54%). The increased workload was managed by flexible working by radiologists and two additional sonographers. Departmental waiting time increased for all patients with same-day patients waiting a median of 35 min (interquartile range 19-60 min). Ninety-one percent (79/87) of same-day patients rated the service excellent or good, but many requested better information on the waiting time.
  
  
  CONCLUSIONS
  There is a demand from GPs for same-day US, and it is feasible in a large hospital with flexible radiology working and increased sonographic staffing. Unless adjacent hospitals offer a similar service, continuing rise in demand could overwhelm the service.
authors.affiliation: Departments of Radiology, Imperial College NHS Trust, London, UK.
authors.forename: K E
authors.initials: KE
authors.lastname: Hawtin
authors.forename: S
authors.initials: S
authors.lastname: Hameed
authors.forename: R
authors.initials: R
authors.lastname: Ramachandran
authors.forename: C J
authors.initials: CJ
authors.lastname: Harvey
authors.forename: A K
authors.initials: AK
authors.lastname: Lim
authors.forename: P
authors.initials: P
authors.lastname: Gishen
authors.forename: M E
authors.initials: ME
authors.lastname: Roddie
mesh_terms: D001071:Appointments and Schedules; D005194:Family Practice / Q000706:statistics & numerical data; D005240:Feasibility Studies; D006297:Health Services Accessibility / Q000458:organization & administration*; D006302:Health Services Research / Q000379:methods; D006786:Hospitals, Urban / Q000458:organization & administration; D006801:Humans; D008131:London; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration; D017060:Patient Satisfaction; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration; D011872:Radiology Department, Hospital / Q000458:organization & administration*; D012017:Referral and Consultation / Q000458:organization & administration / Q000706:statistics & numerical data; D013222:State Medicine / Q000458:organization & administration; D014463:Ultrasonography / Q000706:statistics & numerical data*; D014850:Waiting Lists; D016526:Workload / Q000706:statistics & numerical data