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Dietitian first gastroenterology clinic: an initiative to reduce wait lists and wait times for gastroenterology outpatients in a tertiary hospital service
  1. Rumbidzai N Mutsekwa1,
  2. Russell Canavan2,
  3. Anthony Whitfield2,3,
  4. Alan Spencer1,
  5. Rebecca L Angus1,3
  1. 1 Gold Coast Hospital and Health Service, Nutrition and Food Service Department, Hospital Boulevard Southport, Southport, Queensland, Australia
  2. 2 Gold Coast Hospital and Health Service, Gastroenterology Department, Hospital Boulevard Southport, Southport, Queensland, Australia
  3. 3 Health Sciences, Griffith University, Southport, Queensland, Australia
  1. Correspondence to Ms Rumbidzai N Mutsekwa, Gold Coast Hospital and Health Service, Nutrition and Food Service Department, Hospital Boulevard Southport, Southport QLD 4215, Australia; rumbidzai.mutsekwa{at}health.qld.gov.au

Abstract

Objective The demand for outpatient gastroenterology medical specialist consultations is above what can be met within budgetary and staffing constraints. This study describes the establishment of a dietitian first gastroenterology clinic to address this issue, the patient journey and its impact on wait lists and wait times in a tertiary gastroenterology service.

Design A dietitian first gastroenterology clinic model was developed and a mixed-methods approach used to evaluate the impact of the service over a 21-month period.

Setting Gold Coast University Hospital, Queensland, Australia (a public tertiary hospital).

Patients 658 patients were triaged to the clinic between June 2016 and March 2018.

Intervention A dietitian first gastroenterology clinic for low-risk gastroenterology patients.

Main outcome measures We examined demographic, referral, wait list, wait time and service activity data, patient satisfaction and patient journey.

Results At the time of audit, 399 new (67.9% female) and 307 review patients had been seen. Wait times for eligible patients reduced from 280 to 66 days and the percentage of those in breach of their recommended wait times reduced from 95% to zero. The average time from referral to discharge was 117.8 days with an average of 2.4 occasions of service. 277 patients (69.4%) had been discharged to the care of their general practitioner and 43 patients (10.7%) had an expedited specialist medical review. Patient surveys indicated a high level of satisfaction.

Conclusion A dietitian first gastroenterology model of care helps improve patient flow, reduces wait times and may be useful elsewhere to address outpatient gastroenterology service pressures.

  • nutrition
  • diet
  • functional bowel disorder
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Footnotes

  • Contributors AS, RC and RNM devised the project, the main conceptual ideas and proof outline. RNM and RLA reviewed the literature. RNM and AW extracted the data. RLA and RNM analysed and interpreted the data. RNM and RLA drafted the manuscript. All authors provided critical feedback and helped shape the research, analysis, interpretation of results and revision of manuscript and have read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Gold Coast Hospital and Health Service Ethics Comittee (reference: HREC/17/QGC/191).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Due to our institutional restrictions, there are no data that can be shared. However, further information can be obtained from the corresponding author.

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