T LI1,2, L ARMOUR1,2, A MAKRIS1,2,3, J WONG1,2
1Department of Nephrology, Liverpool Hospital, Australia, 2South Western Sydney Clinical School, University of New South Wales, Australia, 3University of Western Sydney, Australia
Background: Procedures which can be undertaken as an outpatient will reduce the need to admit patients to hospital reducing inpatient burden and may expedite patient care with an overall improved patient experience. A renal-specific day-unit (RDU) was established at Liverpool Hospital to facilitate renal-related procedures.
Aim: The aims of this project were to understand the patterns of activity of the RDU and review the referral system to the RDU.
Methods: A retrospective cohort study was undertaken to review the demographics and encounters at the RDU between June 2015 and April 2020. Data was extracted from the hospital electronic medical record and referrals to the RDU. Statistics performed using SPSS with significance set at p<0.05 with Bonferroni correction as required.
Results: A total of 2850 encounters occurred across the 20 procedures undertaken. The median age of patients was 61 years and 54% were male. The median wait time for procedures overall was 10 days. Iron infusions (32.1%), renal biopsies (27.7%) and vascular access-related procedures (16.4%) were the most common procedures. Out of these procedures, there was a significantly shorter median waiting time (4 days) for vascular access-related procedures when compared to renal biopsies (14 days) and iron infusions (13 days) (p< 0.001). Interpreters were required for 17.8% of encounters in 31 different languages, however the requirement for an interpreter did not delay time to procedure (p=0.6). Referrers had indicated procedure urgency in 58% of referrals. Indication of urgency resulted in a significant difference in days till procedure undertaken (p<0.001).
Conclusions: The RDU was well utilised for a variety of procedures with a short median wait time. Procedures were undertaken in a manner responsive to referrer requirements.
Dr Tracy Li and Dr Luke Armour are resident medical officers at Liverpool Hospital. They will be continuing their training at Liverpool Hospital as basic physician trainees next year.