There is also a need to further explore the skill mix of a multidisciplinary team of nurses, midwives and sonographers, which could facilitate effective running of EPAUs in the absence of senior clinicians. Pinderfields Hospital As you face the toilet pan the transfer space is on the right. The relationship between emergency admissions from Emergency Departments and senior clinician presence, unit volume, and weekend opening hours was investigated by fitting multivariable logistic regression models. We collected data about the total number of Emergency Department attendances and emergency in-patient admissions of women who presented with first trimester pregnancy complications. There are no chairs with armrests available. If necessary, patients can be admitted under the on-call gynaecology team 24 hours a day, seven days a week. Monday to Sunday 08:00 to 13:00. Conceptualization, The type of flooring in walkways and corridors is vinyl/laminate. Dementia friendly signage is not provided. The width of the door opening is 87cm (2ft 10in). If the outcome of your consultation is that you require an ultrasound then our ultrasound scanning appointment times are from 9:30am 4.00pm on weekdays. Clinical follow-up was not standardised but was based on local management protocols and womens medical needs. This national study has been realised thanks to the participation and hard work of 44 Early Pregnancy Assessment Units and their supporting research staff, a large number of patients who took the time to advise us before and during the study, as well as complete questionnaires and take part in interviews, and a number of organisations and individuals, to which we are extremely grateful. The admission rate among 44 units ranged from 0% to 13.7% (median 2.8). The emergency pull cord alarm is not fully functional. Where applicable, participants gave informed written consent before taking part in the study. Peter Brocklehurst reports grants and personal fees from MRC, grants from MRC, NIHR HS&DR, NIHR HJTA, Wellcome Trust, personal fees from AG Biotest, outside the submitted work. The drop-off point is located on Beaumont Place. All rights reserved. The Early Pregnancy Unit is an emergency referral service providing care for women experiencing pregnancy complications, primarily pain or vaginal bleeding, up to 15+6 weeks. The car parking facilities are for Blue Badge holders only. You may find that certain parts of the These data were collected retrospectively at the end of the three-month period corresponding to the date when the last woman recruited to the cohort study was discharged from each hospitals EPAU. The dimensions of the accessible toilet are 212cm x 220cm (6ft 11in x 7ft 3in). Parking spaces for Blue Badge holders do not need to be booked in advance. If you are having a problem in early pregnancy, your first contact should be with your GP, or the out-of-hours service when your GP surgery is closed. Otherwise, we will assume that you're OK to continue. We are a nurse-led service, supported by sonographers and the on-call gynaecology medical team, including a lead consultant . Visualization, The lift is approximately 24m (26yd 9in) from the Elizabeth Garrett Anderson Wing main entrance. Roles The Early Pregnancy Unit (EPU) provides care and support for women up to 21 and 6 days weeks gestation who may be experiencing problems in their pregnancy. The transfer space is obstructed by a waste disposal bin. The main object of the service is to minimise unnecessary hospital admissions, which benefits both patients and the staff. The contrast between the external door and wall is good. Staff do not need to be notified for use of the lift. The nearest standard toilets are located on the ground floor of the Elizabeth Garrett Anderson Wing. Walk-in Centres The height of the reception counter is low (76cm or lower) . A total of 205 EPAUs which completed the survey reported on unit location, opening hours, access to services, and staffing configurations. COVID-19 information from Public Health Wales, Cardiff and Vale Local Public Health Team, Gynaecology Oncology - The Woman's Cancer Centre for Wales. There are volunteers available for help and assistance at the hospital. Validation, There is an/are accessible toilet(s) within this venue designated for public use. As you face the toilet the wall-mounted grab rails are on both sides. Your local early pregnancy unit will be able to advise you as to whether your symptoms warrant . Detailed information, also You can find more information about these on the patient information page. The toilet roll holder is placed higher than 100cm (3ft 3in). MASS Ltd is a business consultancy specialising in analytics, data modelling, and workforce planning and configuration. If you are unable to book an appointment, or need to see a GP out of hours, call your surgery and follow the advice provided. MASS (NK) was commissioned by and became a member of the VESPA co-applicants group to provide the required workforce modelling expertise and knowledge. There is a level turning space (minimum 185cm x 210cm) in front of the payment machine(s). A summary of all units showing their characteristics in respect to the key factors of interest and outlining participants median age, parity, deprivation score, ethnicity and gestational age at presentation is provided in Table 1. View Accessibility Symbols. From the north of the city there are several routes from the M27, from the north east the A33 offers the best route towards the hospital. View on a map. We value all people andstrive to beopen, honest and accountable for the care provided. Methodology, The ramp/slope is located in front of the entrance. Traffic light controlled pedestrian crossing points are located adjacent to each tube station. Upon completion of data collection, we revisited the activity in all 44 units. There is sufficient space to write or sign documents on the low section of the desk. There is step free access to the reception area/desk. Hospital staff do not receive disability awareness / equality training. Resources, Supervision, In addition, patients/carers should be encouraged, where they know the date and time of their next appointment, to get their dispensation notice prior to leaving the hospital. There is a/are clearly marked/signposted Blue Badge parking bay(s) available. Our findings are in contrast with the results of previous studies in other clinical settings, which showed that involvement of more experienced clinicians in delivering emergency care results in a significant reduction in emergency hospital admissions and the length of stay in hospital [12, 18]. To obtain mobility aids please contact the main reception. Copyright 2023 AccessAble. This avoids the need for patients/carers to park illegally on the day while they come in to get their dispensation notice. Access to Early Pregnancy Unit and Gynae Assessment Unit is via the Level D entrance. Competing interests: I have read the journals policy and the authors of this manuscript have the following competing interests: MM, VG, GA, ZA, NK, JH, GB, RBA, JS, DJ has nothing to disclose. We obtained similar results whether we analysed for senior clinician presence as a binary outcome or as a continuum. Twenty-three units were open during weekends. Wherever possible, all data relating to hospital admissions provided by the IS departments were crosschecked by a member of the research team against ward admission books/databases in an attempt to check their accuracy. Writing original draft, Assistance may be required because there is/are slopes/ramps. Do you want to change or cancel an appointment? Validation, Warren Street (bus stop W) no's 18 and 205. In addition, we recorded the amount of time senior clinicians (consultant gynaecologists) spent working in EPAUs which is of critical importance when assessing the impact of their presence on various clinical outcomes. Turn left as you pass through the doors and continue ahead. Software, The lift does have a visual floor indicator. If you are experiencing heavy bleeding and/or severe pain, or feeling dizzy, please go straight to the Emergency Department. c) previous ectopic pregnancy We would like to thank Ms Heidi Chandler; whose hard work and dedication was instrumental in securing the funding for this study. There is level access to the consultation / treatment room. If you are under 5 weeks of pregnancy it may be more suitable to contact your GP for further advice and support. The following buses are used to access the University College Hospital (UCH): Tottenham Court Road - Northbound (Warren Street station) - no's 10, 73, 24, 29, 134. Bearing in mind that women attending the ED are eight times more likely to be admitted than those seen in the EPAU, keeping EPAUs open over the weekend reduces the overall number of emergency admissions to hospital. The admission rates by patient characteristics is shown in Table 2. There is not a play area or toys/books for a child to play with. Elizabeth Garrett Anderson Wing (EGA) is not located within the congestion zone. There is a waiting area close to the reception point. WF1 4DG. Cancer Centre dispensations that the UCH main reception team are unable to deal with will be forwarded to the Cancer centre team at. The room does not have background music playing. Unit volume was defined as the number of patient visits per year and was estimated using the time taken to obtain data on the required number of patients and the average number of visits per patient. There is step free access, via lift, to Clinic 3 - Early Pregnancy Unit. Mirrors are placed at a lower level or at an angle for ease of use. We listen to patient feedbackto deliver patient-centred care. There is level access to the consultation / treatment room. The drop off bays are on the side of the access road to the car park and there are no kerbs. The width of the door opening is 86cm (2ft 10in). 023 8077 7222. You can also self-refer if you have had your booking appointment with your midwife in our hospital, or have a previous history of molar or ectopic pregnancy. However, our study is the first large prospective study designed with a specific aim to study emergency admission rates in women presenting with acute first trimester pregnancy complications. Contact us. The upper gestational age limit was set at 13+6 weeks gestation in order to keep recruitment from all participating EPAUs consistent. e) three or more previous miscarriages There is a space for a wheelchair user to manoeuvre. There is not a clear knee recess beneath the low section of the desk. A . GAU is a 24 hour service and can offer advice and . Due to the current Covid-19 restrictions, we ask that you do not bring childrento your appointment. The early pregnancy and acute gynaecology unit (EPAGU) is an emergency unit. We see women in the first 18 weeks of pregnancy only. Methodology, A key is not required for the accessible toilet. Women are often contacted on the same day, or the next working day if the referral is received after 3pm. Discover a faster, simpler path to publishing in a high-quality journal. We are actively involved in studies developing diagnostic tests and in particular the use of ultrasound diagnostics. Current constraints on health expenditure have compelled providers to explore ways of delivering a greater proportion of care in outpatient settings whilst maintaining good clinical outcomes and high levels of patient satisfaction. There is not a Patient Advice and Liaison Service (PALS) at the hospital. A member of staff is available to assist with opening the door if required. When we compared actual with planned senior clinicians presence, we found that in only 3/19 units (16%) did senior clinicians spend more than 15% of their time actively delivering clinical care, and in 13/19 units (68%) their actual documented presence was less than 5%. The height of the toilet roll holder is 118cm (3ft 10in). There is not a dropped kerb from the drop-off point. When entering the Elizabeth Garrett Anderson Wing main entrance continue past reception and turn right towards the lift. Wakefield Outside of clinic opening hours, patients are triaged in A&E and can be offered gynaecological assessment and ultrasound if an urgent clinical need is identified. The towel dispenser can be reached from seated on the toilet. Sexual health, contraception and HIV services, Vaginal bleeding and/or pain in early pregnancy up to 16 weeks, A loss of liquor before 16 weeks (watery vaginal loss), A positive pregnancy test and ascanresult showinga pregnancy of unknown location with pain, bleeding or other relevant symptoms, A previous ectopic pregnancy (at sixweeks gestation they can be referred for a scan). There is step free access at this entrance. We found that, in general, the actual amount of time spent by the senior clinicians in the units was less than planned, and in only five units, they were present for more than 5% of the time (Fig 3). The height of the intercom is 134cm (4ft 5in). The soap dispenser can be reached from seated on the toilet. EPAU is located on Level 2, Area 7, Burnley General Teaching Hospital. The department/service does play background music. There is a/are door(s) leading into the department/service. The lighting levels at the reception point are good. Both units accept referrals from GPs, the urgent care centre, the antenatal clinic and A&E. . The IHE receives funding from, and collaborates with, government, academic, not-for-profit and private sector organisations. The Early Pregnancy Unit runs in parallel with the Gynaecology Assessment Unit (GAU) and provides services for women with complications of pregnancy such as pain or bleeding up to 16+6 weeks gestation. Fitting multivariable logistic models, we found an association between the emergency admissions from the Emergency Department and weekend opening (p = 0.037). For more information about PLOS Subject Areas, click The door(s) is/are double width but one door is locked. The car park does not have a height restriction barrier. 33 days (IQR 2447) was the median time for units to complete recruitment. There are not separate entry and exit doors in the lift. View photos. You can find some more helpful advice regarding nausea and vomiting in pregnancy on the Pregnancy Sickness Support website, here. Visit website. Blue Badge parking bays cannot be booked in advance. To determine whether the participation of consultant gynaecologists in delivering early pregnancy care results in a lower rate of acute hospital admissions. Miscarriage Association, 2023 Northern Ireland Maternity and Parenting. You should contact the Early Pregnancy Unit if you have a positive urine pregnancy test, and are experiencing pain and or bleeding from 5 to 20 weeks of pregnancy. These responses were used to categorize the units according to three factors: planned senior clinician presence (yes or no); weekend opening (yes or no); and the annual volume of patients, as reported by the corresponding clinicians (low volume <3000 appointments per year vs. high volume 3000 appointments annually). Writing review & editing, Affiliation On entering via the Level D entrance continue ahead and the entrance to the Early Pregnancy Unit and Gynae Assessment Unit department is on the right. All rights reserved. Mobility aids are available to help patients move around and include; wheelchairs. The car park does have a barrier control system. After yourscan, you will be reviewed by one of the specialist nurses who will then discuss with you the likely cause of your symptoms, whether you need to have any more investigations, and your treatment options. Our team isproudto provide compassionate care during anxious times in early pregnancy, when you may be experiencing pain and/or bleeding or have had a previous ectopic or molar pregnancy. Formal analysis, Between the hours of 21:45 and 06:00, when the main entrance is closed, you may use the Maternity entrance situated at the end of the hospital at Glasgow Road. The lift is located to the right as you enter the Elizabeth Garrett Anderson Wing main entrance. Take the lift to the lower ground floor and on exiting turn right and go through the double doors. t: 020 7794 0500 ext 38205 or 31468. Validation, The hospital entrance is not clearly visible from the car park. The entrance door(s) does/do contrast visually with its immediate surroundings. Continuing will take you away from the The toilet roll holder can be reached from seated on the toilet. There is a/are door(s) into the day room/lounge area. There is a/are manual, heavy, double door(s) between the lift and the department/service. There is not a play area or toys/books for a child to play with. An Early Pregnancy Unit in the United States: An Effective Method for Evaluating First-Trimester Pregnancy Complications. The female toilet facilities that were surveyed are located to the left as you pass through the waiting area. On your first visit to UCH or the UCH Macmillan Cancer Centre you need to park your car and bring the following to the reception desk - your valid Blue Badge, your vehicle registration document or Motability documents, proof of hospital attendance, showing appointment time and date e.g. As part of this assessment, they may ask for investigations that may be performed on the same day or within urgent time frames and a management plan will be made for you. We are closed in Bank holidays. Funding acquisition, b) vaginal bleeding https://doi.org/10.1371/journal.pone.0260534.t005, https://doi.org/10.1371/journal.pone.0260534.t006. The other possibility is that senior clinicians, who are fully trained in general obstetrics and gynaecology, lack the additional clinical and ultrasound skills necessary for the effective running of an EPAU. These are further broken down by diagnosis in Tables 3 and 4. https://doi.org/10.1371/journal.pone.0260534.g001, https://doi.org/10.1371/journal.pone.0260534.t002, https://doi.org/10.1371/journal.pone.0260534.t003, https://doi.org/10.1371/journal.pone.0260534.t004. The role of the commercial company MASS Ltd, as an elite researcher in workforce modelling, was advisory with regards to data collection and analysis. There are not volunteers available for help and assistance at the hospital. There is not a flashing fire alarm beacon within the waiting room / area.

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