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Pre-admission clinics in ENT: A national audit of UK practice and opinion

Published online by Cambridge University Press:  29 June 2007

Mohammed El Naggar
Affiliation:
Department of Otolaryngology, North Riding Infirmary Research Foundation, Middlesbrough, UK.
Andrée Welsh
Affiliation:
Department of Otolaryngology, North Riding Infirmary Research Foundation, Middlesbrough, UK.
Andrew J. Dickenson
Affiliation:
Department of Otolaryngology, North Riding Infirmary Research Foundation, Middlesbrough, UK.
Liam M. Flood*
Affiliation:
Department of Otolaryngology, North Riding Infirmary Research Foundation, Middlesbrough, UK.
John G. Gibb
Affiliation:
Department of Otolaryngology, North Riding Infirmary Research Foundation, Middlesbrough, UK.
*
Address for correspondence: Mr Liam Flood, F.R.C.S., Department of Otolaryngology, North Riding Infirmary Research Foundation, Newport Road, Middlesbrough, Cleveland TS1 5JE. Fax: 01642 231154

Abstract

A one-year prospective audit (1989) of patient non-attendance for elective surgery in our department showed that of those summoned, five per cent defaulted on the day of admission without contacting the hospital (Hampal and Flood, 1992). Contributing factors such as lengthy waiting lists and inefficient communication with the patients were amenable to correction by the hospital. However, the current admission policy made inevitable a significant waste of theatre time.

The pre-admission clinic (PAC), an outpatient attendance shortly before planned surgery, was recommended in ENT practice by Robin (1991) and introduced into our department that year. Failure to attend the PAC allowed adequate time' for replacement on the theatre list and was recommended as a solution to the problem of unfilled theatre sessions (Dingle et al., 1993).

A subsequent four-year experience of conducting PACs has confirmed several expected advantages. However, some of the hopes for development expressed in our earlier work (Dingle et al., 1993) have failed to materialize. This study aims to review retrospectively our experience and compare it with the admission practice and desires of ENT departments in the United Kingdom as revealed by a postal survey. The findings are of relevance to all surgical specialties and to anaesthetic departments wishing, to adopt this system of admission.

Type
Audit Article
Copyright
Copyright © JLO (1984) Limited 1997

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References

Caiman, K. (1993) Working Group on Specialist Medical Training. Hospital Doctors: training for the future. London: Department of Health.Google Scholar
Dawes, P. J. D. (1994) Informed consent: questionnaire survey of British Otolaryngologists. Clinical Otolaryngology 19: 388393.CrossRefGoogle ScholarPubMed
Dingle, A. F., Bingham, B., Krishnan, R., Gibb, J. G., Thompson, C. J., Flood, L. M. (1993) Pre-admission assessment clinics: an answer to non-attendance for ENT operations. Clinical Otolaryngology 18: 415418.Google Scholar
Dowling, S., Barrett, S., West, R. (1995) With nurse practitioners, who needs house officers? British Medical Journal 311: 309313.CrossRefGoogle ScholarPubMed
Fisher, E. N., Moffat, D. A., Quinn, S. J. (1994) Reduction in junior doctors hours in an otolaryngology unit. Annals of Royal College of Surgeons England 76: 232235.Google Scholar
Hampal, S., Flood, L. M. (1992) Why patients fail to attend for ENT operations: a one year prospective audit. Clinical Otolaryngology 17: 218222.CrossRefGoogle ScholarPubMed
Hartley, C., Rothera, M. (1994) A new deal for ENT Surgeons. The Manchester Experience 1992–1993. Annals of Royal College of Surgeons England 76: 228231.Google Scholar
Koay, C. B., Marks, N. J. (1996) A nurse led pre-admission clinic for elective ENT surgery: the first eight months. Annals of Royal College of Surgeons England 78: 1519.Google Scholar
Le Noble, E. (1991) Pre-admission Possible. Canadian Nurse 6: 1820.Google Scholar
Livingstone, J., Harvey, M., Kitchin, N., Shah, N., Wastell, C. (1993) Role of pre-admission clinics in a general surgery unit: a six month audit. Annals of Royal College of Surgeons England 75: 211212.Google Scholar
Lunn, J. M., Mushin, W. N. (1982) Mortality associated with anaesthesia. London, Nuffield Trust; 20.Google Scholar
MacPherson, D., Lofren, R. (1994) Outpatient internal medicine preoperative evaluation: a randomised clinical trial. Medical Care 32: 498507.Google Scholar
Miller, D. K. (1993) The rationale and benefits of a required pre-admission ambulatory surgery program. Journal of Post Anaesthesia Nursing 3: 3942.Google Scholar
NHS Management Executive (1991) Junior Doctors: the new deal. London: Management Executive.Google Scholar
Pearson, R. M., Jago, R. H. (1981) An evaluation of a preoperative anaesthetic questionnaire. Anaesthesia 36: 4549.CrossRefGoogle ScholarPubMed
Porter, K. M. (1985) Orthopaedic audit. Review of inpatient waiting lists. British Medical Journal 291: 12161217.Google Scholar
Robin, P. E. (1991) Pre-admission clinics. British Medical Journal 302: 532.Google Scholar
Rudkin, G. E., Osborne, G. A., Doyle, C. E. (1993) Assessment and selection of patients for surgery in a public hospital. Medical Journal of Australia 158: 308312.Google Scholar
Senters, E. (1991) Admitting and registration. Care Finance 20: 2531.Google Scholar
Zeitoun, H., Ahmed, I., Robinson, P. (1994) Validity of a patient administered questionnaire for routine otolaryngology admissions. Clinical Otolaryngology 19: 410–41.Google Scholar