부산대학교 도서관

Background Post-operative follow-up for post oesophago-gastric resection patients are usually conducted by clinicians. Follow-up normally continues for a 5-year period. In high volume tertiary NHS centres, there is an increased demand for outpatient clinician episodes. We have successfully trialled and implemented a model using Allied Healthcare Professionals (AHP); consisting of a Cancer Nurse Specialist (CNS) and Specialist Dietician (SD). We propose that AHP follow-up in the outpatient department is cost-effective and beneficial to patients. Methods An AHP clinic was implemented in our regional tertiary unit in February 2017. All post-operative patients without any on-going complications were eligible to attend the AHP clinic from their second outpatient visit. Data was collected from February 2017 to January 2018. The data was prospectively collected and retrospectively analysed. The AHP follow-up clinic was conducted by a CNS & SD, which runs in parallel with a consultant led clinic. Each patient in the AHP clinic is given an extended 30-minute consultation, compared to a standard 10-minute consultant appointment. This allows for queries to be addressed thoroughly and investigations required to be made. Results During this initial trial period, there were 44 AHP clinics with 197 outpatient consultations; average of 4.5 patients per clinic. There was good outpatient attendance compliance and improved patient satisfaction. In more recent patients, assessment for pancreatic insufficiency, iron, folate, B12 and vitamin D deficiencies were assessed and treated. 27 of 77 (35%) had symptoms of pancreatic insufficiency, 6 of 57 (12%) had low folate, 4 of 52 (7%) had B12 deficiency and 6 of 26 (23%) had vitamin D deficiency. All patients with deficiencies were given supplementation. Conclusion AHP follow-up from their second visit is safe, improves patient contact and satisfaction. Nutritional deficiencies can be detected and treatment commenced by AHPs without detriment to patient outcome. This provides a platform for cost effective use of resources. AHP follow-up increases consultant outpatient episodes available for the hospital trust. In the next phase, the AHPs intend on having 270 patient consultations per year (6 patient consultations per clinic with 45 clinics per year) with a standardised nutritional deficiency assessment. Disclosure All authors have declared no conflicts of interest. [ABSTRACT FROM AUTHOR]