Liver patients warm to hot clinic
Liver specialists have dramatically reduced the amount of time patients spend in hospital by introducing a twice weekly ‘hot clinic’ speeding up discharges and minimising the risk of readmission.
An earlier review found emergency liver rate admissions (41.6%) at LNWH significantly higher than the national average (37.2%).
Patients were also spending an average of ten-and-a-half days in hospital because of consultants’ concerns about the length of time for routine outpatient appointments.
Patients living with conditions including hepatitis and cirrhosis were often waiting six to eight months which fell well short of the nationally recognised Get It Right First Time (GRIFT) review.
It is designed to improve the treatment and care of patients through in-depth review of services, benchmarking, and presenting a data-driven evidence base to support change.
It was one of several tasks facing incoming consultant hepatologist and clinical lead Jayshri Shah who found a service needing a complete makeover.
“I like a challenge and I certainly got that. We have a two week pathway for cancer patients, however it is difficult to see a sick liver patient in that time frame in the outpatient clinic, the Hot Liver clinic is a step to address the gap.
“The good news is we are in a far better place than a year ago and are now preparing for national accreditation. It’s been a huge effort but I’m proud of the team which we are in the process of expanding.
“Many of these patients have serious conditions like cirrhosis of the liver and the hot clinic provides better monitoring of their health and early interventions to reduce the need for admission.”
Length of stay has subsequently been halved from 10.5 to 4.5 days with fewer hospital stays which were costing the trust an average of £3,000 per patient.
This project was submitted to British Society of Gastroenterology to be considered for the clinical service development prize and received a commendation.