'One stop' haematuria clinic in Fremantle Hospital, Western Australia: a report of the first 500 patients

Abstract

What's known on the subject? and What does the study add? Haematuria is a symptom of urologic cancer particularly bladder cancer and timely diagnosis can prevent disease from progression to a more advanced or incurable stage. The 'One Stop' Haematuria clinic is the first rapid assessment clinic for haematuria in a public hospital in Western Australia. The results from this study have confirmed that it is an efficient and effective model in the streamlined care of patients with haematuria and provides evidence to support a more widespread adoption of this model of care.

Objective: • To report the prospective outcomes and clinic process for the first 500 patients at a new 'one stop' Haematuria Clinic (OSHC) in a Western Australian public hospital.

Patients and methods: • The first 500 patients who attended the weekly OSHC between May 2008 and February 2011 were included in this paper. • Patients with haematuria were referred by various specialties. Gender, age, outcomes following OSHC attendance, diagnoses and wait times were recorded.

Results: • In all, 311 males and 189 females presented to the clinic with visible haematuria (296 cases) and microscopic haematuria (204 cases). • Sixty-six new cancers (13.2%) were diagnosed, 63 urological and three non-urological. • Fifty-one patients (10.2%) were diagnosed with transitional cell carcinoma of the bladder. Further breakdown of staging for bladder transitional cell carcinoma diagnoses were stage Ta (23 patients), stage T1 (21 patients) and stage 2-4 (seven patients). • Sixty-nine patients (13.8%) were diagnosed with urological pathologies requiring surgery. Thirty-four patients (6.8%) were followed up by the nurse practitioner or continence advisors. In all, 61.2% of patients were discharged after a single visit to the OSHC. • Excluding those requiring surgery only 3.4% patients required further urologist follow-up.

Conclusion: • The results have demonstrated that the first OSHC in a public Western Australian hospital is an efficient and effective model for the streamlined care of patients with haematuria. • We encourage that similar models are adopted in other public hospitals in the region.