Authors (including presenting author) :
KWOK SW(1), NGAN TK(1), TANG WY(1), AU WK(1), KAM WS(1), YUEN KL(1), SAE LO K(1),
LAI SY(2), WONG WSJ(2), WU PH(3), NG CF(1,4), LI SYC(1)
Affiliation :
(1) Department of Surgery, PWH. (2) Department of Surgery, NDH. (3) Department of Surgery, AHNH.
(4) SH Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong.
Introduction :
The IMSN Clinic - The Integrated Model of Specialist Outpatient Service through Surgical Nurse Clinic (Urology) in NTEC was implemented from October 2018, with the aim to provide fast track assessment for patients with haematuria. After having the clinic for two years, we would like to review our results and see whether the initial goal could be achieved.
Objectives :
To review the outcomes of the IMSN clinic (Urology) in NTEC in the detection of significant pathology.
Methodology :
Retrospective review of data of all patients with haematuria referred to IMSN clinic were reviewed from Oct 2018 to Mar 2020 and also another group of patients referred to urology clinic (SOPD) before the commencement of IMSN. The results of the two groups would be compared.
Result & Outcome :
In the period between Jan – Jun 2018, prior to the commencement of IMSN clinic, 228 new haematuria cases were seen in SOPD and then had flexible cystoscopy (FC) done, and the median time from referral to first consultation in SOPD (RtoC) and time from first consultation to flexible cystoscopy appointment (CtoFC) were 93.5 days and 36 days respectively. Among these patients, 10 patients were diagnosed to have malignancy and required surgery. After the IMSN clinic implemented, 1948 patients were assessed during the period between Oct 2018 to Mar 2020, the median time for RtoC and OtoFC appointment were 22.5 days and 69.5 days respectively. Among these patients, 53 patients were diagnosed to have malignancy and required surgery. The median time of referral to OT time for pre-IMSN and IMSN periods were 216 days and 140.5 days respectively.
Conclusion:
The IMSN model had shown to help to shorten the waiting time from referral to the time for first consultation and to time of operation for cancer cases. This would help to improve the management of patients with haematuria.
