title: A prospective audit of emergency urology activity in a university teaching hospital.
abstract: BACKGROUND
  Urology cover is commonly available out-of-hours in most teaching hospitals. However, increased pressure to reduce hospital expenditure has forced many institutions to consider removing middle grade cover outside of normal working hours. The aim of this study was to audit the emergency urology activity in our institution over a 12-month period.
  
  
  METHODS
  A prospective logbook was maintained for all urology referrals from the emergency department between August 2012 and March 2013. The diagnosis and patient outcome was recorded for each referral. The emergency theatre logbook was retrospectively evaluated for all emergency urology procedures carried out over the same time period. A basic cost analysis was performed to calculate the cost of providing the on-call service.
  
  
  RESULTS
  A total of 752 patients were referred to the urology service over a 12-month period. The most common reasons for referral were renal colic and scrotal pain. Approximately 41 % of referrals were discharged directly from the emergency department. There were 167 emergency operations performed in total. The majority of emergency operations and referrals from the emergency department took place outside of normal working hours. A basic cost analysis revealed an associated cost saving of €58,120.
  
  
  CONCLUSIONS
  Emergency urology activity constitutes a large proportion of the workload at our institution. Restricting emergency urology cover would limit essential training opportunities for urology trainees, increases length of stay and delay treatment of urological emergencies. Urology "out of hours" cover is a cost-efficient method of service provision.
authors.affiliation: Department of Urology, University Hospital Limerick, Dooradoyle, Limerick, Ireland, elaine.redmond@ymail.com.
authors.forename: E J
authors.initials: EJ
authors.lastname: Redmond
authors.forename: J C
authors.initials: JC
authors.lastname: Forde
authors.forename: M A
authors.initials: MA
authors.lastname: Abdelrahman
authors.forename: N P
authors.initials: NP
authors.lastname: Kelly
authors.forename: C
authors.initials: C
authors.lastname: Akram
authors.forename: S K
authors.initials: SK
authors.lastname: Giri
authors.forename: H D
authors.initials: HD
authors.lastname: Flood
mesh_terms: D039602:After-Hours Care / Q000458:organization & administration / Q000706:statistics & numerical data*; D003365:Costs and Cost Analysis; D004630:Emergencies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008485:Medical Audit; D010561:Personnel Staffing and Scheduling; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013520:Urologic Surgical Procedures / Q000706:statistics & numerical data*; D014572:Urology / Q000458:organization & administration / Q000706:statistics & numerical data*