1167 A Closed Loop Audit to Benchmark Care for Emergency Department Attendances with Renal Colic

Aim Benchmark care against the NICE Standards for assessment and management of Renal Colic patients. Produce patient leaflet highlighting stone diet. Re-audit and assess care for renal colic patient, following he introduced changes in first cycle including patient leaflet & renal order-set. Highlight areas that may need improvement and improve the awareness clinicians. Method Using electronic system and notes, care for the most recent 150 patients attending St Heliers and Epsom A&E, coded on system as “Ureteric Stones”, was benchmarked against NICE guidance during two cycles (2022 & 2023) as bellow:CTKUB request, completion, and report timeTime between arrival, prescription, delivery & choice of analgesiaTime between arrival and Urological intervention.Proportion who had bone profile requested.Proportion that received stone diet advice as per documentation. Results 100% CTKUB was reported within 24HRs (97.9% cycle 1). 71.9% of total patients received NSAIDS as analgesia in cycle 2 (54.5% cycle 1). 100% who required surgical intervention, had it within 48HRs in cycle 2 (70% cycle 1). 94.7% had calcium requested in cycle 2 (77.9% in cycle 1). In cycle 1, only 8.7% received dietary/fluid advice, this is improved to 39.4% in cycle 2. Conclusions Department currently successful in meeting the NICE quality standards for timing of CTKUB and Surgical management of ureteric stones. We have improved by 17.4% in prescribing appropriate analgesia and by16.8% improvement in serum calcium requests. Department improvement by 30.7% in giving patient advice regarding lifestyle and dietary changes for secondary prevention.