650 Standardised Management of Ureteric Colic: A Quality Improvement Project

Aim Ureteric colic is a condition that contributes a significant amount to the workload of both emergency and urological services. The standards of its management are outlined by the British Association of Urological Surgeons (BAUS). We therefore endeavoured to evaluate the effectiveness of our treatment centre in achieving these standards with the aim to develops a new diagnostic pathway to improve the efficiency of managing ureteric colic. Method A pre-post intervention study design was used. The first cycle evaluated all ureteric colic cases referred to our department between September-October 2022. Data was extracted using local clinical and radiological software in line with local clinical governance guidelines. We subsequently developed a treatment pathway in conjunction with our emergency department to guide both diagnosis and initial management of acute presentations. The second cycle was performed during September 2023 to assess the efficacy of our pathway. Results Of the 37 new acute ureteric colic referrals reviewed during our second cycle, (Mean age: 48 years, Male: Female 2.4:1), 100% received their CT scan within the target window of 14 hours (Mean time: 02:12). 80% had correct Xray imaging performed which demonstrated a relative increase of 30% from the previous cycle (80% vs 50%). Furthermore 75% of patients had non-steroidal anti-inflammatory drugs (NSAIDs) prescribed and 70% had the correct blood tests done (Calcium and Urate). Conclusions Our pathway has demonstrated a significant improvement in the efficiency and accuracy of our department’s management of acute ureteric colic.