Authors (including presenting author) :
Lee S (1), Cheuk C (1), Choi YK(1), Ng TK (1), Lee MK (1), Leung KW (1)
Affiliation :
(1) Department of Family Medicine, NTEC
Introduction :
The waiting time of a routine trans-abdominal ultrasound scan is long in Hospital Authority. This may lead to extra workload in SOPD as patients might have repeated followups and consultations before the scan.
Objectives :
A trial of TASC with doctor consultation and trans-abdominal scan was launched in the triage clinic of Department of Family Medicine in PWH since Oct 2021. We studied the impact of this service model on reduction of double referrals to SOPD and Department of Radiology for US assessment.
Methodology :
All cases who were referred to Family Medicine Specialist Clinic (triage clinic) would be screened for eligibility and directed to TASC. The ultrasonography service in TASC focused on trans-abdominal scan including hepatobiliary and urinary system. The case inclusion for hepatobiliary scan included deranged liver function, elevated alpha fetal protein, hepatic or gallbladder lesions requiring monitoring, and suspected symptomatic gallstone. The inclusion criteria for urinary scan included deranged renal function, renal lesions requiring monitoring and patient with loin pain. This clinic was run by family medicine specialists with ultrasound experiences (who achieved Master degree in sonography). We recruited all cases in TASC from 10/2021-9/2023. Their consultation notes were reviewed retrospectively.
Result & Outcome :
A total of 191 new cases were seen in the clinic from 10/21-9/23, with 309 attendances.The average age of patients was 61.5 years. 51.3% was male. 72.4 % of patients was referred for hepatobiliary problems, and 27.1 % for urinary problem, 0.5% for pancreatic problem. After assessment in TASC, only 25 cases (13.1%) required referrals to SOPDs for further assessments. The number of referrals to Department of Radiology, PWH, for additional imaging after TASC was only 9 (4.7%), i.e 95.3% reduction in US requests to Hospital Authority. 8 (4.2%) patients were referred for private imaging . 71.2% (136 cases) of our cases were discharged, after an average of 1.53 visits. To conclude, TASC was promising in significantly reducing referrals to both SOPDs (Department of Medicine or Surgery) and Radiology.
