Benefit of a nurse-led telephone-based intervention prior to the first urogynecology outpatient visit: a randomized-controlled trial

Maria Jimènez Torres,Klara Beitl,Wolfgang Umek,Hanna Mayer,Julia Hummel Jimènez,Sonja Zehetmayer,Nikolaus Veit-Rubin

doi:10.1007/s00192-020-04318-0

Abstract

Introduction and hypothesisTriage has become a valid tool to reduce workload during the first consultation in a specialized clinic. A nurse-led telephone intervention prior to the first urogynecologic visit reduces visit duration and increases patients’ and physicians’ satisfaction.MethodsAll patients scheduled for their very first visit were recruited. They were randomized into an intervention group (prior contact by a specialized urogynecology nurse) and a control group (no contact). The intervention included a questionnaire about history and symptoms. Patients were prompted to complete a bladder diary. Primary outcome was duration of the consultation; secondary outcomes were patients’ and physicians’ satisfaction with the intervention.ResultsFifty-five patients were allocated to the intervention group and 53 to the control group with no difference regarding age, BMI, parity, menopausal status and primary diagnosis. Mean duration of the telephone call was 10.8 min (SD 4.4). The consultation was significantly shorter in the intervention group than in the control group (mean difference: 4 min and 8 s, p = 0.017). In the intervention group, 79% of the patients found the consultation quality “excellent,” 86% would return, and 77% would recommend our clinic to a relative or friend compared with 68%, 67% and 66%, respectively, in the control group. Physicians were “very satisfied” or “satisfied” with the patient preparation.ConclusionsA nurse-led intervention reduces the duration of the first uroynecologic consultation and is associated with high patient and physician satisfaction. Further research should evaluate whether it also decreases the number of follow-up visits and further referrals.

Highlights

Introduction and hypothesisTriage has become a valid tool to reduce workload during the first consultation in a specialized clinic
Between April and November 2017, we recruited a total of 108 patients scheduled for their very first urogynecologic visit out of a total 190 patients scheduled for an outpatient clinic visit
Two patients in the intervention group could not be reached by phone, and five patients in the control group did not attend

Summary

Introduction

Introduction and hypothesisTriage has become a valid tool to reduce workload during the first consultation in a specialized clinic. Numerous triage tools have been validated worldwide, such as the Australasian Triage Scale (ATS) the Manchester Triage System [MTS], the Canadian Triage and Acuity Scale (CTAS), the Emergency Severity Index (ESI) or the Swiss Triage Scale (STS) [2,3,4,5,6] These scales represent ready-to-use charts during a clinical setting, and some can be implemented over the telephone. A thorough history taking is a crucial but time-consuming task It includes specific questions about symptoms and signs, related to the pelvic floor, the urinary tract and the bowel function and requires special knowledge by the health care provider. This study aimed to evaluate whether a reduction of the very first visit duration by a previously held specialized nurse-led telephone interview can be confirmed in a different population and whether it improves patient’s and physician’s satisfaction

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Conclusion