Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-09T08:21:43.907Z Has data issue: false hasContentIssue false

The ENT emergency clinic: does senior input matter?

Published online by Cambridge University Press:  21 November 2012

A Mirza*
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Queen's Medical Centre, Nottingham University Hospitals, UK
L McClelland
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Queen's Medical Centre, Nottingham University Hospitals, UK
M Daniel
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Queen's Medical Centre, Nottingham University Hospitals, UK
N Jones
Affiliation:
Department of Otorhinolaryngology, Head and Neck Surgery, Queen's Medical Centre, Nottingham University Hospitals, UK
*
Address for correspondence: Mr A Mirza, Department of Otorhinolaryngology, Head and Neck Surgery, Queen's Medical Centre, Nottingham University Hospitals, Derby Road, Nottingham NG7 2UH, UK Fax: +44 (0)115 919 4486 E-mail: [email protected]

Abstract

Background:

Many ENT conditions can be treated in the emergency clinic on an ambulatory basis. Our clinic traditionally had been run by foundation year two and specialty trainee doctors (period one). However, with perceived increasing inexperience, a dedicated registrar was assigned to support the clinic (period two). This study compared admission and discharge rates for periods one and two to assess if greater registrar input affected discharge rate; an increase in discharge rate was used as a surrogate marker of efficiency.

Method:

Data was collected prospectively for patients seen in the ENT emergency clinic between 1 August 2009 and 31 July 2011. Time period one included data from patients seen between 1 August 2009 and 31 July 2010, and time period two included data collected between 1 August 2010 and 31 July 2011.

Results:

The introduction of greater registrar support increased the number of patients that were discharged, and led to a reduction in the number of children requiring the operating theatre.

Conclusion:

The findings, which were determined using clinic outcomes as markers of the quality of care, highlighted the benefits of increasing senior input within the ENT emergency clinic.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Bolz, M, Streppel, M, Guntinas-Lichius, O. The impact of a university ENT emergency centre for the ambulatory care of ENT emergency patients [German]. Laryngorhinootologie 2011;90:1722 CrossRefGoogle ScholarPubMed
2 Collins, C. The standards for emergency surgical services. J R Soc Med 2001;94:1315 Google ScholarPubMed
3 Fishpool, SJ, Stanton, E, Chawlishly, EK, Hicklin, LA. Audit of frequent attendees to an ENT emergency clinic. J Laryngol Otol 2009;123:1242–5CrossRefGoogle Scholar
4 Council Directive 93/104/EC of 23 November 1993 Concerning Certain Aspects of the Organisation of Working Time. Strasbourg: Council of European Union, 1993 CrossRefGoogle Scholar
5 Daniel, M, Wolstenholme, C, Philpott, CM, Moir, AM. A survey of surgical SHO's opinions on the European Working Time Directive. Ann R Coll Surg Eng (Suppl) 2004;86:322Google Scholar
6 Blencowe, NS, Parsons, BA, Hollowood, AD. Effects of changing work patterns on general surgical training over the last decade. Postgrad Med J 2011;87:795–9CrossRefGoogle ScholarPubMed
7 Powell, J, Cooles, FA, Carrie, S, Paleri, V. Is undergraduate medical education working for ENT surgery? A survey of UK medical school graduates. J Laryngol Otol 2011;125:896905 CrossRefGoogle ScholarPubMed
8 Campbell, J. Inappropriate admissions: thoughts of patients and referring doctors. J R Soc Med 2001;94:628–31CrossRefGoogle ScholarPubMed
9 White, AL, Armstrong, PA, Thakore, S. Impact of senior review on patient disposition in the emergency department. Emerg Med J 2010;27:262–5CrossRefGoogle Scholar
10 Hutchinson, A, Coster, JE, Cooper, KL, McIntosh, A, Walters, SJ, Bath, PA et al. Assessing quality of care from hospital notes: comparison of reliability of two methods. Qual Saf Health Care 2010;19:e2Google ScholarPubMed
11 Wheatley, AH, Temple, RH, Camilleri, AE, Jones, PH. ENT open access clinic: an audit of a new service. J Laryngol Otol 1999;113:657–60CrossRefGoogle ScholarPubMed
12 Surgical training seriously compromised by European Working Time Directive. In: http://www.rcseng.ac.uk/media/medianews/Surgicaltrainingcompromisedbyworkingtimedirective [2 July 2011]Google Scholar
13 Fisher, E, Pfleiderer, A. Is undergraduate otoscopy teaching adequate? An audit of clinical teaching. J R Soc Med 1992;85:23–5CrossRefGoogle ScholarPubMed
14 Philpott, CM, Daniel, M. The European Working Time Directive and its impact on ENT surgery. ENT News 2004;13:76–7Google Scholar
15 Lockyer, J, Ward, R, Toews, J. Twelve tips for effective short course design. Med Teach 2005;27:392–5CrossRefGoogle ScholarPubMed