The Oxford thrombosis service houses an out-patient DVT diagnostic service which has been running since 2000. In 2012, the DVT team led an initiative for a ‘one-stop’ diagnostic DVT service, raising money to secure an intra-departmental ultrasound scanning machine.
With the direct involvement and support of the radiology department, the existing patient pathway for DVT diagnosis was adapted so that all patients undergoing assessment for DVT were offered same day compression ultrasound within the DVT department. The main outcomes that the team has been able to improve are patient satisfaction and diagnostic waiting times.
The Oxford DVT clinic is at a significant distance from the main Churchill Hospital building and radiology department. This, combined with poor patient mobility and reliance on portering staff, often made it difficult for patients to get to ultrasound scanning (USS) appointments on time. Furthermore, patients were frequently returned to the DVT clinic by the portering team following a significant delay. This affected their clinical care and led to delays in patient discharge and an accrual of nursing overtime.
The team felt that these difficulties were unacceptable to the patient group and that the development of a ‘one-stop’ DVT clinic, with on-site USS, would improve the patient pathway and experience while reducing the portering team’s work load.
The objectives of the initiative were three-fold: to obtain an in-house USS machine; to improve patient experience; and to reduce delays in diagnosis.
The remote location of the USS department meant that an uninterrupted patient pathway, from initial assessment by the nurse within the DVT clinic, rapid diagnosis with USS and then timely relaying of results to patients, was compromised. This sometimes meant that patients could not undergo a full clinical assessment by a thrombosis doctor until the following day, due to late return of the patient to the clinic area, necessitating their return to the clinic.
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