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1.
Ann R Coll Surg Engl ; 103(8): 599-603, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1910438

ABSTRACT

INTRODUCTION: The COVID-19 pandemic has demanded radical changes in service delivery. Our centre adopted the use of outpatient telemedicine to reduce close-contact interactions between patients and staff. We hypothesised that incidental gains may be associated with this. We evaluated financial, practical and environmental implications of substituting virtual clinics (VCs) for in-person urology outpatient appointments. METHODS: VCs were studied over a 3-month period. Based on patient-reported 'usual mode of transport' to the hospital, travel distance, time, petrol and parking costs, and the carbon emissions avoided by virtue of remote consultations were calculated. The underlying symptom/diagnosis and the 'effectiveness' of the VC were evaluated. RESULTS: Of 1,016 scheduled consultations, 736 (72.44%) were conducted by VCs over the study period. VCs resulted in an agreed treatment plan in 98.4% of a representative patient sample. The use of VCs was associated with an overall travel distance saving for patients of 31,038 miles (49,951km) over 3 months, with an average round-trip journey of 93.8 miles (151km) avoided for each rural-dwelling patient and an average financial saving of £25.91 (€28.70) per rural-dwelling car traveller. An estimated 1,257.8 hours of patient time were saved by avoidance of travel and clinic waiting times. Based on car-travelling patients alone, a 6.07-tonne reduction in carbon emissions was achieved with the use of VCs. CONCLUSIONS: In appropriate clinical circumstances, VCs appear to provide efficiency across a number of domains. Future healthcare may involve offering outpatients the option of telemedicine as an alternative to physical attendance.


Subject(s)
Cost Savings , Remote Consultation , Travel , Vehicle Emissions , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19 , Female , Humans , Male , Middle Aged , United Kingdom , Urology , Young Adult
2.
Ir Med J ; 113(8):157, 2020.
Article in English | PubMed | ID: covidwho-1136766

ABSTRACT

Aim COVID-19 has posed an unprecedented challenge to healthcare systems. We aimed to observe the impact on urological care delivery in an Irish university hospital. Methods Data on urological activity was prospectively collected for 3 months from March 2020. A retrospective review of the same period in 2019 was performed for control data. Results Over the 2020 study period, 356 urological admissions were recorded;a 23.1% decrease from the 2019 corresponding period(n=463). A 21.7% decrease in flexible cystoscopies was seen (162 versus 207). 125 theatre cases (36 off-site) were performed in the 2020 period, versus 151 in 2019. Emergency case load remained stable, with 69 cases in the 2020 period. The percentage of trainee-performed cases was preserved. COVID-era outpatient activity increased, to involve 559 clinic consultations compared to 439 the preceding year;a reflection of annual growth in service demand and facilitated by virtual clinic application (n=403). There were 490 instances of patients cancelling/failing to attend outpatient appointments, compared to 335 in 2019. Conclusion The Irish COVID-19 outbreak has created obstacles for urological care. Nonetheless, urgent/emergent urological cases persist. Our unit has managed this to-date with flexible adaptation of service delivery. The global challenge posed by COVID-19 will demand ongoing resourcefulness to minimise impact on patients with time-sensitive urological conditions.

3.
European Urology Open Science ; 20:S4, 2020.
Article in English | EMBASE | ID: covidwho-1108856

ABSTRACT

Introduction: COVID-19 has posed an unprecedented challenge to healthcare systems, via both its direct threat and a ripple effect on hospital services. Rapid emergence of COVID-era guidelines has ensued, suggesting a paradigm shift in surgical practice.1–3 We aimed to observe the impact on urological care delivery in an Irish university hospital. Methods: Data on urological activity was collected prospectively for 6 weeks from February 2020. A retrospective review of the same calendar period in 2019 was performed to obtain control data. Variables collected included admissions, elective/emergency cases, endoscopy/ESWL, nurse-led clinic and outpatient figures. Results: Over the 2020 study period, 118 urological admissions, including non-endoscopy day cases, were recorded, demonstrating 53.4% decrease from 2019 corresponding period (n = 253). A 51.2% decrease in flexible cystoscopies was seen (65 versus 133). 44 elective theatre cases (18 off-site at a private hospital) were performed in the 2020 period, compared to 63 in 2019. Major elective case numbers remained stable (n = 5). Laparoscopic work continued where surgically appropriate. In contrast to other figures, emergency case load increased by 180% to 54 cases in the 2020 period. Prospectively studied outpatient activity, compared to control period figures in brackets, involved 350(400) clinic consultations, 348(155) cancellations and 52(63) DNAs. 92 consultations were by virtual clinic. Conclusions: The early phase of the Irish COVID-19 outbreak has changed delivery of urological care. Nonetheless, emergency and urgent elective urological cases continue to present in similar numbers. The global challenge posed by COVID-19 will demand ongoing flexibility and resourcefulness to minimise the impact on patients with time-sensitive urological conditions.

4.
Irish Medical Journal ; 113(8):1-8, 2020.
Article in English | Scopus | ID: covidwho-826551

ABSTRACT

Aim COVID-19 has posed an unprecedented challenge to healthcare systems. We aimed to observe the impact on urological care delivery in an Irish university hospital. Methods Data on urological activity was prospectively collected for 3 months from March 2020. A retrospective review of the same period in 2019 was performed for control data. Results Over the 2020 study period, 356 urological admissions were recorded;a 23.1% decrease from the 2019 corresponding period(n=463). A 21.7% decrease in flexible cystoscopies was seen (162 versus 207). 125 theatre cases (36 off-site) were performed in the 2020 period, versus 151 in 2019. Emergency case load remained stable, with 69 cases in the 2020 period. The percentage of trainee-performed cases was preserved. COVID-era outpatient activity increased, to involve 559 clinic consultations compared to 439 the preceding year;a reflection of annual growth in service demand and facilitated by virtual clinic application (n=403). There were 490 instances of patients cancelling/failing to attend outpatient appointments, compared to 335 in 2019. Conclusion The Irish COVID-19 outbreak has created obstacles for urological care. Nonetheless, urgent/emergent urological cases persist. Our unit has managed this to-date with flexible adaptation of service delivery. The global challenge posed by COVID-19 will demand ongoing resourcefulness to minimise impact on patients with time-sensitive urological conditions. © 2020, Irish Medical Association. All rights reserved.

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