By Harry R. Dalton, H.R. Dalton, S.H. Hussaini, I.A. Murray, J.L.H. Wong
Sanatorium guide: Gastroenterology presents functional guidance at the scientific and administrative matters linked to working a gastroenterology-based outpatient clinic.Written with all contributors of the outpatient group in brain, the publication presents key details on prognosis; making plans and implementation of therapy; sufferer schooling and source management.Clinic instruction manual: Gastroenterology is key analyzing for somebody contemplating developing, or presently thinking about, an outpatient hospital during this box.
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Extra resources for Clinic Handbook: Gastroenterology
Referral and access Ease of access to the jaundice service for the referring clinician is pivotal to its success. The referral process should be straightforward and available both in and out of hours. A 24-hour answering service, fax machine or the use of electronic referrals may be appropriate depending on local resource availability. Referring clinicians should be encouraged, however, to provide the patient with a written referral on attendance. Vetting of referrals by a clinician should be avoided, if at all possible, as this will often introduce delays in the system, especially out of hours.
The timing, frequency and capacity of the clinic will depend partly on the local demand for such services. However, to prevent unacceptable delays between referral and attendance, clinics should be held at least twice per week. Experience with such services has shown that demand can soon outstrip supply. Auditing of pre-existing demand for such services will enable more efficient planning. Clinic location will depend upon local resources. Outpatient departments, short-stay wards, medical admissions units and even endoscopy units may be appropriate.
A rectal examination should be performed if there is any suggestion of a neoplastic cause for the jaundice, rectal bleeding or recent change in bowel habit. Neurological Particular attention should be paid to the presence of encephalopathy as this necessitates admission in the acutely jaundiced patient. Look for cognitive impairment, constructional apraxia and liver flap. A reversed sleep pattern may suggest low-grade encephalopathy. Initial investigations Laboratory investigations The availability of investigations will depend on the local laboratory policies.
Clinic Handbook: Gastroenterology by Harry R. Dalton, H.R. Dalton, S.H. Hussaini, I.A. Murray, J.L.H. Wong