OUTCOMES OF A LONGER INITIAL ASSESSMENT APPOINTMENT TIME INCORPORATING POINT OF CARE ULTRASOUND (POCUS) IN AN INTEGRATED CLINICAL ASSESSMENT AND TREAT
Damian Honey, Kent Community Health NHS Trust
Musculoskeletal ultrasound has gained increasing popularity due to its ability to provide rapid diagnosis of common MSK conditions, comparable clinical utility compared to other diagnostic modalities, high patient satisfaction and cost effectiveness.
The aims of this pilot trial were to establish the clinical and cost effectiveness of incorporating PoCUS into all peripheral MSK appointments within an integrated clinical assessment and treatment service (ICATS). Appointment times were increased from 30 to 45 minutes to provide time to incorporate PoCUS. Data were collected over a period of 16 weeks, and outcomes included further investigations, injection at appointment, impact on follow-up numbers and patient satisfaction.
Results showed 92 patients were seen in total, and 85 of those received a point-of-care ultrasound scan at the first appointment. The pilot trial showed a significant decrease in patients requiring follow-ups (21% compared to 46% prior to the pilot commencing). Significantly fewer MRIs were ordered (13% compared to 19% prior to the pilot commencing). 14 landmark Injections and 6 ultrasound-guided injections were carried out at the first appointment. This represents a cost saving, compared to pre-pilot data showing 11% of patients requiring injection needed a follow-up appointment to complete the procedure. Patient satisfaction surveys demonstrated high patient satisfaction with the standard of assessment and service offered by incorporating PoCUS in their initial assessment.
In conclusion, better access to PoCUS provides an effective method for reducing referrals for diagnostic investigations, reducing follow-ups within the service, allowing for injections at the first appointment, and creating high patient satisfaction within an integrated clinical assessment and treatment service (ICATS).