# Impact of the Urology Assessment Unit on the Emergency Urology Patient Pathway

## TL;DR

A new Urology Assessment Unit improved patient access and reduced waiting times compared to the previous Surgical Assessment Unit.

## Contribution

The study demonstrates the effectiveness of a dedicated Urology Assessment Unit in managing emergency urology patients more efficiently.

## Key findings

- The UAU saw more patients (207) than the SAU (111) over four weeks.
- 55.9% of UAU patients were seen within 30 minutes, compared to fewer self-referrals in the SAU.
- District nurse referrals increased in the UAU, and ANPs supported management of common urology cases.

## Abstract

Objective

A Urology Assessment Unit (UAU) was developed to allow direct access for emergency urology patients. This study compared the new UAU patient pathway with the previous Surgical Assessment Unit (SAU), looking at the source and type of referrals, the time to assessment and decision-making for patients' discharge or admission to hospital from the unit.

Subjects/patients (or materials) and methods

Retrospective data collection and analysis using admission diaries and online patient portals were conducted for four weeks for patients seen in the SAU (October-November 2019) and a four-week period after the establishment of the UAU (September 2023) at the Aneurin Bevan University Health Board in Caerleon, Newport, Wales.

Results

A total of 207 patients attended the UAU over four weeks, compared to 111 in the SAU. The UAU had more patient self-referrals, 44 patients (21%), while in the SAU, there were five patients (4.5%). District nurses referred 15 patients (7%) to the UAU and none to the SAU. In the UAU, 104/186 (55.9%) patients were seen within 30minutes.

Conclusion

The UAU was associated with a higher number of urology patients seen and with shorter documented waiting times, with prompt management decisions made with the senior urology input. Advanced nurse practitioners (ANPs) are allowed to support in managing common urological presentations. The sources of patient referrals changed with increased district nurse referrals and patient self-referrals to the UAU.