Evaluation of the Registrar on call activity in a tertiary care urology unit

1. Evaluation of the Registrar on call activity in a tertiary care urology unit Rajpal S, Venugopal S, Patterson J, Rosario D Department of Urology, Royal Hallamshire Hospital, Sheffield

2. On call activity of urology registrar • Background: • With EWTD, no SHO for day oncall – calls directly to registrars • Can we optimise the types of calls and improve training time? • Materials and methods: • 120 logged calls through were looked into for type of referral, source of referral, appropriateness, level of input needed. Urology Consultations: The Hidden Workload? http://dx.doi.org/10.1308/147363510X535250

3. On call activity of urology registrar • Results: • Though majority of the calls were appropriate (71%), they were not emergency (only 19%) requiring on-call support. • Conclusion: • Development of online referral system • Red, amber and green referrals • Call the on call registrar for all the red referrals (acute urological emergencies). • This will free up valuable training time for registrars • (new referrals generated through the amber and green system are logged on the referral pathway - ££££!!!!)

4. Evaluation of the Registrar on call activity in a tertiary care urology unit Rajpal S, Venugopal S, Patterson J, Rosario D Department of Urology, Royal Hallamshire Hospital, Sheffield Introduction The implementation of the EWTD has resulted in restructuring of hospital on call teams. The urology day on call working pattern in our unit had to be modified as a consequence. We sought to assess the day time on call registrar activity and categorise the type of referrals and sources. With the information gained, we aim to change the referral process ensuring a balance between good patient care and optimal training opportunities. Fig 1. Chart showing the source of referrals Fig 4. Model template 1 of the online referral system Material and methods All middle grades participating in the on call rota were invited to complete an activity sheet prospectively. The proforma included time of the referral, source, urgency (emergency, urgent, routine), action taken and whether the referrals were appropriate or not as judged by the individual. Fig 2. Clinical presentations of the referrals A total of 120 referrals were logged over a four month period. Calls from SHO level trainees formed the maximum activity (31%), followed by general practitioners (19%) and FY1’s (16%). 25% of the referrals were routine, 56% urgent and 19% were emergencies. Nearly one third (29%) of the referrals were deemed inappropriate and were mainly from other specialities within the hospital. Results Fig 5. Model template 2 of the onlinereferral system Fig 3. Appropriateness of the referrals Conclusions Our results show that nearly a third of the day on call activity included routine patients and patients whose care did not require involvement of the on call registrar. With the information available, we are developing an electronic referral (fig 4,5)system which could differentiate urgent from routine referrals and ensure better use of valuable training time.