Redefining urogynaecology services: the impact of nurse-physiotherapist triage clinics on reducing delays and improving patient care

Abstract

Introduction and Hypothesis This project aimed to evaluate the impact of a nurse-physiotherapist triage clinic (NPTC) on service delivery within a urogynaecology department. The NPTC model was designed to be the first point of contact for urogynaecology referrals to supplement a consultant-led model and was run by specialist nurses and pelvic floor physiotherapists. The project period spanned one year before and one year after the NPTC’s introduction. Methods This was a service evaluation project registered with the local clinical governance team (reference number GYNAE374). A retrospective review of 200 case notes compared patients referred before the NPTC’s establishment, pre-NPTC or group 1 (100 new patients), with those referred afterwards, post-NPTC or group 2 (100 new patients), with ensured comparability of primary reasons for referral between both groups. The patient selection for group 1 was conducted using statistical software R version 4.4.2 (R Foundation for Statistical Computing, Vienna, Austria). Results The process measure for the project was to determine whether implementation of the NPTC reduced time intervals between general practitioner (GP) referral to first appointment and from the first visit to treatment completion. In both analyses, the NPTC showed significant reduction in the time intervals. The time interval between GP referral and first appointment was significantly reduced in group 2, with a p value of < 0.001. Similarly, the time interval from the first visit to treatment completion was shorter for group 2, with a p value of < 0.001, demonstrating the NPTC’s efficiency in accelerating the care process and reducing treatment timelines. The balance measure was to investigate patient satisfaction, using feedback forms, which was overwhelmingly positive; 95% of respondents rated the clinic’s service as ‘excellent’, and 5% rated it as ‘good’. Conclusions The NPTC model provides an effective, resource-efficient solution to urogynaecological service delivery, demonstrating its potential as a benchmark for modern urogynaecological practice. This was a successful quality improvement journey that can lead the way for adaptation of the same approach by different units.