Three Year Retrospective analysis of Pleural Procedure Services

Introduction: Pleural diseases are recognized as important subspecialty in respiratory medicine as the incidence rises internationally. Pleural daycase services offer one-stop clinical assessments, imaging and intervention aiding early diagnosis, improved patient care and admission avoidance. They offer educational benefits including procedural skills and clinical research opportunities. Method: A retrospective analysis of patients presenting to the Ambulatory Pleural Procedure Services (APPS) between September 2015 to November 2018 was conducted. Patient characteristics, source of referral, diagnosis, outcome and intervention conducted were evaluated including patient satisfaction survey. Results: 721 patients were reviewed during this time. Total pleural procedures performed were 378. 106 were therapeutic, 219 diagnostic and therapeutic, 29 diagnostic only and 24 Indwelling Pleural Catheters. Majority of the referrals are from the secondary care (70%) and 30% are from the primary care. With this service we saved 2443 days of hospital bed days. On average referral to appointment time for urgent suspected cancer was 8 days and for others it was 13 days indicating the efficiency of this service, feedback survey from the patients was very positve. Conclusion: Our dedicated pleural services have resulted in improved patient outcomes and positive feedback from the patients. It has facilitated early diagnosis, appropriate MDT referral and avoided prolonged inpatient admissions. In addition it has had educational benefits to junior doctors in improving their pleural procedure competencies. Reference: Hooper CE, Welham SA, Maskell NA. Pleural procedures and patient safety: a national BTS audit of practice. Thorax 2013;70(2):189-191.