Article Text
Abstract
Current Post-TURP follow up protocol is for patients to attend hospital to provide urinary tests and complete a symptom questionnaire. The evidence based practice information is limited and my research to clarify this showed the questionnaire is the primary tool for follow up. Clinic attendance is a drain on staff time, local resource for urinary tests and associated higher cost to NHS but also a burden for patients as the expense of travel, time waiting for tests and interrupting their working/social activity. As such a change towards telephone clinics would potentially benefit all.
Follow up clinics were amended in a step wise fashion to prevent confusion of wholesale changes, initially patients would attend clinics as usual but only undergo questionnaire assessment. This was then advanced to telephone clinics with the questionnaire once this practice became standard culture.
The University of Birmingham Surgical Leadership programme provided an education in how to effect change. This included understanding one-self, how teams interact, processes/systems of change and conflict resolution. There was also inspiring and experienced speakers including Dame Clare Marx (ex-president of Royal College of Surgeons), to provide case studies and real life practice experience.
I approached this project initially with evidence to provide confidence the changes were appropriate, and performed an open meeting with the urology department to discuss planning and in particular engaging the experiences of the specialist nurses who would be effecting the change. This final step would be most important as they already had knowledge the difficulties of such clinics but also had the most invested in the change.We came to a combined template of future plans which included updating standard letters, clinic timings, patient opinion but also a plan to any we flagged as a concern.