Audit and Re-Audit on Outpatient Hysteroscopy

 

OBJECTIVES

To assess the sources of referrals, review time and

understand the main reason for referral to outpatient

hysteroscopy (OPH)

To assess how well we are achieving best practice for

hysteroscopy

Through this audit, we aim to improve the quality of care

provided to patients attending OPH.

METHODS 

Retrospective data collected (01/06/2023-31/07/2023) on the OPH

hysteroscopy proforma. Total patients = 54.4 excluded: 2 required

appointment in the vulval clinic,1 for Mirena removal, 1

inappropriate referral

Re-Audit data collected 01/06/23-31/07/23. Total patients = 99. 14

excluded: 3 for Mirena coil removal, 4 inappropriate referrals,1

declined outpatient hysteroscopy, 5 x DNAs and 1 discharged

from rapid access clinic.

RESULTS:

Audit 2022: All patients (100%) were verbally consented and

appropriately counselled. 82% patients have analgesia prior to

procedure. 3 patients had analgesia during the procedure (2 had

local anaesthetic and 1 had entonox). 85% patients had

diagnostic hysteroscopy, 9.7% had operative hysteroscopy, 4.8%

had both procedures. 98% had vaginoscopy hysteroscopy.

Ultrasound recording for 98% patients and 30% RAC patients

were seen within 3 weeks

Re-Audit 2024: All patients (100%) patients gave written consent

and 97% had appropriate counselling. 94% had analgesia prior to

procedure. 92% had ultrasound findings recorded. 92.7% had

vaginoscopy OPH. 80% had adiagnostic procedure, 13.2% had

diagnostic and operative hysteroscopy, and 6% had only

operative hysteroscopy. Total patients referred from rapid access

clinic was 58% and majority were seen within 2-3 weeks.

 

CONCLUSIONS

Recommendations of Audit 2022: We propose a Proforma for

OPH. Patients should have written consent and referral to

OPH should be timely and appropriate to avoid overburdening

the services. This will improve referral especially from rapid

access clinics patients. Since this audit, we have introduced

written consent form and OPH proforma to our department to

provide the best care and services to the patient

Recommendations of Re-Audit 2024: Written consent should

be used in all OPH clinics. OPH proforma continued to be

used. All patients should have ultrasound prior to procedure.

RAC patients should be seen within 2-3 weeks of referral.

Outpatient gynaecology manager should disseminate

information to record BMI in all patients.