Proposal form Evaluation of a Healthcare Innovation

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Outline/Proposal FormEvaluation of a healthcare innovation in practice (clinical audit with pre- and post-change evaluation)Student’s Name andProfessionWorking Title(Maximum 30 words)Plain CT KUB as a First Diagnostic Option for Renal Colic PatientsIn Sohar HospitalAudit areaGive the topic andprofessional/clinical area for yourresearch.Plain CT KUB as a First Diagnostic Option for Acute Renal ColicPatients in Sohar HospitalRadiology DepartmentAudit questionMust be accurate, succinct andanswerableCan Plain KUB CT scan be used as the first diagnostic option for acuterenal colic patients at Sohar Hospital?Aims/ObjectivesConsider primary and secondaryaims/objectives for your audit.1)Establish new imaging protocol for acute renal colic patients.2)Minimise renal colic patient`s radiology waiting list.3)Reduce renal colic patient’s treatment pathway.A new Lithotripsy Unit has been recently introduced in Sohar Hospital.This study aims to establish new imaging protocol in order to help renalcolic patients in terms of diagnosis and treatment pathway as the currentimaging protocol is complicated.Brief justification for workBrief review of the key literature,demonstrating ‘need’ for theresearch and possible clinicalrelevance or implications(Maximum 250 words)Computed tomography of the kidneys, ureter and bladder (CTKUB) has become the reference technique in medical imaging forrenal colic patients, to diagnose, plan treatment and exploredifferential diagnosis. Despite the limitations and the radiation riskof CT scan; CT KUB is the accepted gold standard investigation forsuspected renal colic and it replaces intravenous urography (IVU)in many hospitals because it is a diagnostically superior (sensitivity97-98 %, specificity 96 – 100 %), contrast-free, quicker, safer andmore cost effective investigation for acute renal colic (Bariol et al.,2005;Chowdhuryet al., 2007;Kennishet al., 2008; Yong, 2009;CML June2015
Patatas et al., 2012).Sohar Hospital in Oman is a 400 bed hospital which serves a populationof over half a million people, and it has only one CT machine and twoultrasound machines which are used for eight hours every day a week.In fact, with reference to the statistics of Radiology Department atSohar Hospital; there were about 1420 CT KUB examinations donein the period between January 2013 and July 2016, all thosepatients definitely have done some radiological examination asinitial investigation such as: US, IVU or plain KUB x-ray (SoharHospital, 2016). This means that patient radiological investigationwas delayed (appointments after 3 months), increased risk ofpatient radiation dose, increased risk of contrast reaction andunnecessary waste of radiological facilities which of course endwith complicated patient management and treatment pathway.Early and accurate diagnosis of renal colic which is crucial as it plays amajor role in the early management of the condition as well as posttreatment planning (Ripolles et al., 2004; Rucker et al., 2004).Feasibility CheckDetail where and how you havechecked for existing research inthis area, and show how yourquestion will add to any existingresearch (Include key referencesyou have found)Two ways of search were conducted in order to check how this issue ismanged with other institutions.1)A survey of clinical protocols being used in Oman hospitals will becarried out to find out how each hospital manages renal colicpatients. This will be a telephone interview with the Head ofRadiology Department of individual hospitals.2)Initial literature review of radiology journals, which was conductedvia Hertfordshire University study net library through researchengines such as: PubMed, Science Direct, CINHAL Plus.(see appendix 1 for a list of references)Proposed methodologyDetail your approach and auditdesign. eg proposed change/s andtheir measurement and evaluation,data collection methods, sample,recruitment, etcType of analysis: detail how youThe initial methodology of this study wasamixed method designfor data collection. Mixed method is used to combine qualitativeand quantitative data in order to maximise the strengths of each,CML June2015
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