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Transcript of Nitin Mukerji 1, John Crossman 1, Joanne Lewis 2, Philip J Kane 3 1 Department of Neurosurgery,...
![Page 1: Nitin Mukerji 1, John Crossman 1, Joanne Lewis 2, Philip J Kane 3 1 Department of Neurosurgery, Newcastle General Hospital 2 Department of Oncology, Freeman.](https://reader035.fdocuments.us/reader035/viewer/2022081603/5697bff41a28abf838cbd452/html5/thumbnails/1.jpg)
‘On-call’ referral patterns of patients with diagnosis of brain tumour: An audit of activity in in
two neurosurgical centres
Nitin Mukerji1, John Crossman1, Joanne Lewis2, Philip J Kane3
1Department of Neurosurgery, Newcastle General Hospital
2Department of Oncology, Freeman Hospital3Department of Neurosurgery, James Cook University Hospital
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Background
Patients with a diagnosis of brain tumour commonly referred as ‘on call’ emergencies
Referral taken by the ‘on call’ registrar and discussed with the ‘on call’ consultant
Advice given on management
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Implications
EWTD
Advice variable
May not be discussed with a consultant with interest in tumour management
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AimsTo audit pattern of referrals into the two
neurosurgical units in NECN
Identify patterns in referral which have potential for modification:improve patient careImprove EWTD compliance
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MethodologyDevelopment of ‘on-call’ referrals database at
both units (NM)Completed by on call registrar at end of on-call
periodPatient demographics, reason for referral, advice
given Piloted at JCUH and then introduced to NGH
All referrals in one year period audited (2009)
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Results
4751 referrals
451 tumour related9.5% of all on call referrals
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Pattern of referrals
Time of day During week
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Pattern of tumour referrals
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Peak times of tumour referrals
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Sources of referrals
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Specialties that refer tumours
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Source of referrals: time of day
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Grade of referring doctors
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Referring hospitals-JCUH
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Referring hospitals-NGH
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Results15% of ‘On-call’ neuro-oncology referrals were
received out of hours
50% of ‘On call’ neuro-oncology referrals were received between 11am and 5 pm.
70% of ‘On call’ neuro-oncology referrals had a GCS 14 or 15
<1% of ‘On call’ neuro-oncology referrals needed emergency surgery
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DiscussionImportant baseline data
Monitor impact of transfer of NGH unit to RVI
Scope to develop guidelines to ensure direct referrals to a neuro-oncology
Scope to reduce OOH workload and compliance with EWTD
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Further Work
Extend audit to include 2010
Subgroup analysis
Model effects of propsed guidelines