Authors (including presenting author) :
Ng SL(1), Lai TCT(2), Tsang CF(2), Ho BSH(3), Ng ATL(3), TSU JHL(4)
Affiliation :
(1)Urology Nurse Consultant, Department of Surgery, Queen Mary Hospital,(2)Associate Consultant, Department of Surgery, The University of Hong Kong,(3)Consultant, Department of Surgery, The University of Hong Kong, (4)Division Head & Consultant Department of Surgery, The University of Hong Kong.
Introduction :
The Integrated Service Model is a new model of care to patient receiving Specialist Out-patient (SOP) service since 2018. Under this model, the clinical pathway is pre-defined with clear criteria for each new case intake, follow-up and discharge process among 7 clusters. Patients presented with urological problems receive the same standard of care in different hospitals.
Objectives :
The application of integrated service model in urology nurse clinic can enhance patients’ care by (1) early cancer detection; (2) prompt management of urgent urological cancer diseases; (3) unnecessary emergency admission and (4) shorten hospital stay.
Methodology :
Patients have urological problems such as haematuria and lower urinary tract symptoms are referred to nurse clinic for early assessment and diagnosis. By adopting an integrated model, we can provide prompt and standard interventions in order to have early cancer detection and subsequent surgery arrangement. Patients can contact the nurse clinic during office hour for any urological problems such as haematuria or blockage of urethral catheter so that they do not require to attend AED service or unnecessary emergency admission. The urology nurse assessed the patient on arrival of nurse clinic and provide prompt management according to the management protocols.
Result & Outcome :
There were 1134 eligible patients assessed in nurse clinic under integrated service model during 2021-2022. Majority of them have their first medical consultation in 2023-2025. There were 369 females and 765 males. There were 70 patients, accounted for 6.17% have newly diagnosed of urological cancers. And 2 patients (0.18%) found ca stomach or ca pancreas which have referred to EGI or HBP team accordingly. Among these 70 patients, there were 41 patients had newly diagnosed of bladder cancers in which 6 of them required radical cystectomy with urinary diversion. The hospital stays shortened from 8-10 days to 4-5 days due to the concrete multidisciplinary approach. There were 13 patients diagnosed prostate cancer and 16 patients diagnosed kidney cancer. All of them have surgery arranged.
Patients under this integrated service model can receive precise and standard of care according to the pre-define clinical pathway. It can help us to detect early urothelial cancers that require prompt urological management. Eventually, patient’s quality of care can be benefited.
