DVT trial proves successful: ODHB

A trial to speed up treatment for patients suspected of having deep vein thrombosis has meant some patients have avoided lengthy waits in the Dunedin Hospital emergency department.

In a report on the project, Otago District Health Board GP liaison officer Dr Anne Worsnop, has described it as successful in breaking down barriers and improving communication between community and hospital care.

"It opens the way for other patient groups to be managed within the community."

A sense of trust was being developed about the capability of the GPs, the report said.

Under the scheme, general practitioners have been able to directly arrange ultrasound scans for patients with suspected deep vein thrombosis (DVT).

They have also been able to prescribe a drug, Clexane, if a scan was to be delayed for more than six hours.

This medication was previously only available through the hospital.

The GPs were provided with additional information about diagnosing DVT as part of the project.

Results from the first three months show that the total number of scans requested by the GPs decreased over the trial period.

This was contrary to concerns that the number of scans would increase due to easier access.

Almost two-thirds of the 107 patients seen by GPs were given a scan appointment time which eliminated the emergency department wait, which had averaged about three and a-half hours.

For some patients, the amount of time spent in the department would be much higher because they would have had to return more than once to receive Clexane if their scan waiting time was longer than about six hours.

They also had to return to wait in the department for a review after a negative scan for further assessment, diagnosis and treatment, but under the trial this could be done in the community.

The report showed that the ratio of positive scans had increased, possibly reflecting that a "best practice diagnostic pathway" was being used.

Dr Worsnop said it was being recommended that the process be made permanent.

The way results are relayed has been listed as an area which needs improvement.

A report which will go to the board hospital advisory committee this week shows that in September the emergency department was busy.

Patient numbers exceeded 45 on many days, and many patients spent time on beds in the corridor.