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अमूर्त

Prospective Assessment of Urologic Consultations at a Tertiary Care Referral Center

Maria Voznesensky

Urologic consultation is an essential service provided by urology divisions. We examined urology call coverage diagnoses, acuity and management at an academic tertiary care referral center. Data was prospectively collected for all urologic consultations over a 3 month period. Patient age, consultation location, diagnosis, level of acuity, encounter time, and management was recorded. Eight attending physicians, three residents and one physician assistant provided coverage. 869 telephone encounters were documented, and 857 had analyzable data. Average age was 60.1 years. There were 85 pediatric calls (10%). Urgent encounters involved 19% of patients; 81% were considered elective. Stones, infection and urinary retention were the most common diagnoses. 93% of encounters involved patients from our institution or the urology faculty practice. Of 857 encounters, 180 (21%) required patient contact, while 677 (79%) were managed over the telephone. Average phone call length was 8 minutes, and 569 (84%) calls were under 10 minutes. Face-to-face encounters lasted 43 minutes on average. Procedures were needed in 63 (35%) encounters: bladder catheterization in 27 (43%), transurethral surgery in 20(32%), and ureteroscopy in 16 (25%). Management of these procedures was split between the inpatient floor in 32 (51%), and operating room in 31 (49%). Our data show that the majority of consults in an academic tertiary care referral center involve common non-emergent conditions, usually manageable over the telephone in a reasonable period of time. Clinical data describing the experience “on-call” informs residency curriculum development and defines hospital urologic coverage needs.