Implementation of an Electronic Endoscopic Stent Register in a District General Hospital in the National Health Service (NHS), United Kingdom

Introduction Serious and life-threatening complications can occur from the delayed removal of biliary stents. A robust system is needed to ensure the timely removal of stents. We aimed to evaluate our practice of using a stent register to remove stents on time and identify system failures that contribute to missed stent removals. Method A new electronic stent register was introduced in our endoscopy service of a busy district general hospital under the National Health Service (NHS) in the United Kingdom. This register was initiated to support the tracking of patients who had biliary stents placed to ensure that this is removed on time. We analysed the usefulness of our register in managing patients who had a biliary stent placed. Data was extracted from the database after a 20-month data collection period. Collected data included stent type and follow-up plans. The electronic record was examined for clinical course and evidence of removal. Results Over the study period, 414 patients underwent endoscopic retrograde cholangiopancreatography (ERCP), and 89 patients had stents placed. After clinical review, 82 cases were managed appropriately. In seven cases, stents were overdue for removal. The reasons for delay were: patient preference (n=1); relocation out of area (n=2); and inadequate follow-up (n=4). The register also identified patients with oesophageal and lumen-apposing metal stents, all of whom had appropriate follow-up and removal plans documented. Conclusion Inadequate follow-up documentation and unclear responsibility for ongoing surveillance were identified in the majority of genuinely overdue cases. Implementation of an electronic stent register successfully identifies patients with overdue stent removal or exchange. Successful implementation of a stent register requires regular clinical oversight and consistent staff engagement.