Objectives Early pregnancy loss occurs in 15–20% of clinically-confirmed pregnancies. A dedicated early pregnancy clinic (EPC) with provision of diagnostic services such as transvaginal ultrasonography and on-site laboratory investigations contributes to a reduction of repeated assessments for ectopic pregnancy and miscarriage, and is a necessary facility in every maternity unit. Our objectives were to (i) examine clinical records for EPC attendances, (ii) obtain staff and patient feedback to identify areas for improvement and (iii) review EPC incident reports and complaint forms.
Study design A retrospective audit was performed on EPC attendances during 2011 using clinic databases; subsequently categorised according to referral sources, indications, new cases, diagnosis and management. Incident and complaint forms were analysed for recurrent themes. Staff and patient satisfaction questionnaires were distributed obtaining a random sample of 70 patients and all 24 staff.
Results There were 5,233 attendances during 2011, with GPs the main source of referrals. Emergency room referrals contributed the highest workload for repeat scans and blood tests. While 95% of staff expressed job satisfaction, 83% reported encountering stress attributed to individual workload and co-worker conflict, while junior medical staff were concerned about lack of training. Overall, 95% of patients were satisfied with staff and clinic organisation, with many instead highlighting concerns with the physical space and ability to overhear confidential medical information. All 6 patient complaints related to communication issues.
Conclusion High levels of job satisfaction and good teamwork were identified and we received largely positive feedback. Areas of improvement include staff workload and training.
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