2033 ``Polyclinics'' - a concept of multiple clinic attendance. A pilot quantitative and qualitative review

Abstract

Abstract Introduction The concept of “polypharmacy” is a well-recognised phenomenon, forming a keystone of any comprehensive geriatric assessment. We considered whether a similar concept could be applied to the number of outpatient clinics that patients may attend - a concept we have coined “polyclinic”. We recognise that older populations may have a greater number of comorbidities and, as a result, have more healthcare professionals inputting into their care. Similar to the potential detrimental effects of multiple medications, we were interested to explore if a similar detrimental effect may apply to patients attending multiple clinics. We also attempted to consider environmental and financial impacts. We approached this in both a quantitative and qualitative manner. Method A cohort was selected from all admissions to a subacute Geriatrics ward at University Hospital of Wales during the month of April 2023. National records were used to review the last decade of clinic attendances. For interviews every 4th patient was contacted Results 66 patients (75% female) were identified with 3 exclusions. The average number of clinics attended was 18.4 with 0.36 new diagnoses being made per clinic and 0.69 interventions per attendance. Geriatric clinic attendance yielded both a higher average number of diagnoses and interventions (0.93 and 1.4 respectively). Patient feedback was limited to 8 patients and 7 next of kin. Feedback regarding ‘worthwhileness’ was very positive with ratings >8/10. Feelings about possible cutting back on clinics or virtual clinic attendance were mixed with concerns regarding suitability and access to technology Conclusions We identified several limitations to this pilot project but overall feedback was positive. This study does not have the scope to suggest that attending multiple clinics are detrimental but aims to raise the concept of “polyclinic” that may be overlooked, particularly in a comorbid population and considers potential patient impact and concerns.