VOL: 99, ISSUE: 01, PAGE NO: 33
Jane Healey BSc, RGN, is practice/professional development nurse, gastroenterology unit, Bradford Hospitals NHS Trust.As a practice/professional development nurse working in a busy gastroenterology unit, which cares for increasing numbers of patients with inflammatory bowel disease, I was interested in reading the article by Miller et al on the outpatient management of patients with this condition.
As a practice/professional development nurse working in a busy gastroenterology unit, which cares for increasing numbers of patients with inflammatory bowel disease, I was interested in reading the article by Miller et al on the outpatient management of patients with this condition.
The National Association for Crohn's and Colitis report that there are more than 8,000 new cases every year and that the number of young people presenting with the disease is growing. This has a huge impact upon the gastroenterology service. In addition, the increased screening and subsequent surveillance that will result from the implementation of the cancer plan is set to increase our workload even further.
Staff on our unit are conscious of the need to consider new ways of working in order to meet these additional needs. We are already taking steps to develop a specialist nursing role in inflammatory bowel disease and had considered a number of different aspects that the role could encompass, including a telephone helpline. We had not, however, thought about introducing a structured, telephone system for outpatients as described in the article.
The service outlined is an excellent example of patient-centred care, something we are all trying to achieve. I was particularly impressed with the flexibility it offers to patients. I know from my own practice, that patients often resent having to come into outpatients when they feel well. Offering them a telephone clinic in the evening, or at time that suits them, provides an alternative that meets the needs of all the parties involved: the patient, the health care professional and the gastroenterology unit.
The article included useful information on how the clinics were managed and their effectiveness in reducing outpatient attendance. This rationalisation of appointments ensured that patients who needed to attend clinics experienced shorter waiting times and were given a longer appointment.
Patient feedback highlighted how well the service was received. The one or two negative comments provided in the article were also useful as they prompted us to consider how such a service could be managed during holidays, and to look at the possibility of a telephone follow-up for patients after endoscopy procedures. Comments on the possible disadvantages of the service were also appreciated.
Our unit is based in an area where a high proportion of the population is disadvantaged. In addition there is a large non-English speaking community. If we develop a telephone service, we will need to take this into consideration from the start.
The service described in this article is a simple yet brilliant idea, and we are now aiming to introduce a similar service sometime in the future. We are, therefore, grateful to Miller and her colleagues for bringing it to our attention.