Writing review & editing, Affiliation These are further broken down by diagnosis in Tables 3 and 4. https://doi.org/10.1371/journal.pone.0260534.g001, https://doi.org/10.1371/journal.pone.0260534.t002, https://doi.org/10.1371/journal.pone.0260534.t003, https://doi.org/10.1371/journal.pone.0260534.t004. Disposal facilities are available in the cubicle. They are not issued to carers, relatives, visitors or friends who are Blue Badge holders bringing a non-Blue Badge holder patient to an appointment. For Pregnancy complications occurring beyond the first 16 weeks and up to six weeks post-partum or for Hyperemesis, contact: Maternity Day Assessment Unit. Writing review & editing, Affiliation If you are referred to the unit, an appointment will be offered for the next available clinic based on the following set criteria: Women between 6 - 13 weeks of pregnancy with a . There are not separate entry and exit doors in the lift. You will be given a copy of your ultrasound report. We see women in the first 18 weeks of pregnancy only. (2021) Differences in the organisation of early pregnancy units and the effect of senior clinician presence, volume of patients and weekend opening on emergency hospital admissions: Findings from the VESPA Study. The Early Pregnancy Unit (EPU) provides care and support for women up to 21 and 6 days weeks gestation who may be experiencing problems in their pregnancy. We will also send an electronic copy to your GP. The waiting room / area does have background music playing. This venue does not play background music. Some women may also be advised to monitor their symptoms at home. There is ramped/sloped access at this entrance. As a result, the group prioritised the need for future good quality research into the relative effectiveness of different EPAU configurations [10]. The female toilet(s) is/are approximately 20m (21yd 2ft) from the clinic entrance. Research that could potentially guide recommendations and policies on staffing and configurations of EPAUs has been scarce [69]. The National Institute for Health and Care Excellence (NICE) guideline on Ectopic Pregnancy and Miscarriage (CG 154) [10] included a review of evidence comparing EPAUs with other models of providing early pregnancy care for women presenting with first trimester pregnancy complications. Royal Free London (RFL)offers a seven-dayper week specialist service for women who need emergency care for early pregnancy and gynaecological problems at Royal Freeand Barnet Hospitals. The Unit is open at all times. There is clear signage on the department/service. The Blue Badge bay(s) is/are clearly marked. The door(s) open(s) away from you (push). You can also self-refer if you have had your booking appointment with your midwife in our hospital, or have a previous history of molar or ectopic pregnancy. The admission rates by patient characteristics is shown in Table 2. Statistical models were adjusted for final diagnosis, maternal age at initial visit, deprivation score, and unit referral policy regarding gestational age, as these variables have a known effect on the rate of emergency admissions [1517]. Parking spaces for Blue Badge holders do not need to be booked in advance. The Miscarriage Association The Ectopic Pregnancy Trust Due to the current Covid-19 restrictions, we ask that you do not bring childrento your appointment. Find your hospital ward contact information: This service runs across two sites at Queen Charlottes & Chelsea Hospital and St Marys Hospital. You can also call020 7794 0500 ext 38205 or 31468. We chose to study the rate of emergency admissions which is a recognised quality outcome indicator for acute hospital units [19, 20]. Access to the building between 21:00 - 07:00 is via intercom. Bearing in mind that women attending the ED are eight times more likely to be admitted than those seen in the EPAU, keeping EPAUs open over the weekend reduces the overall number of emergency admissions to hospital. The email address for the Patient Advice and Liaison Service (PALS) is. Language interpreters can be provided on request. Continuing will take you away from the Warren Street (Northern / Victoria Lines) and Euston Square (Circle / Hammersmith & City / Metropolitan Lines) are the closest tube stations to University College Hospital (UCH). You should contact the Early Pregnancy Unit if you have a positive urine pregnancy test, and are experiencing pain and or bleeding from 5 to 20 weeks of pregnancy. Volunteers do not receive disability awareness / equality training. Conceptualization, Based on this study, the sample size of 44 units, each contributing 150 patients, was calculated to give us 90% power to detect a 5% absolute difference in the risk of an emergency admission. That is, a one-hour increase in weekend opening hours was associated with a 3.0% (95% CI: 0.3% to 5.8%) increase in the odds of an emergency admission from EPAU. The dimensions of the accessible toilet are 210cm x 220cm (6ft 11in x 7ft 3in). We strive for continuous improvement and provide evidence based care. Carole Johnston/ NickyHewitt, Clinical Nurse Specialists for early pregnancy. The car parking facilities are for Blue Badge holders only. There is step free access, via lift, to Clinic 3 - Early Pregnancy Unit. a new pregnancy and under the care of the recurrent miscarriage clinic. We have placed cookies on your deviceto help improve our website. However, our study is the first large prospective study designed with a specific aim to study emergency admission rates in women presenting with acute first trimester pregnancy complications. new North Central London GP Website do not work as expected. https://doi.org/10.1371/journal.pone.0260534.t005, https://doi.org/10.1371/journal.pone.0260534.t006. Upon completion of data collection, we revisited the activity in all 44 units. If you feel your symptoms require urgent assessment outside of these hours the wider medical team are here to support you 24 hours a day 7 days a week. Copyright 2023 AccessAble. A total of 205 EPAUs which completed the survey reported on unit location, opening hours, access to services, and staffing configurations. The contrast between the wall-mounted grab rails to the left of the toilet and wall is poor. The distance between the floor and the highest table is 43cm (1ft 5in). If you develop worrying symptoms during pregnancy or you need to discuss any underlying medical conditions in pregnancy, there are several places that you can turn to for advice: Midwife Both units accept referrals from GPs, the urgent care centre, the antenatal clinic and A&E. The route from the car park to the hospital entrance is not clearly signposted. There is a horizontal wall-mounted grab rail on the opposite side of the seat to the transfer space. Index of Multiple Deprivation (IMD) was calculated based on the home address postcode of the patient at the time of patient recruitment. There is / are 1 Ultrasound Room(s) available. This information is for the entrance located on Level D of the hospital, opposite the entrance to the car parks. clinic appointment letter. Despite the fact that an advanced training module in acute gynaecology and early pregnancy has been running for a number of years from The Royal College of Obstetricians and Gynaecologists, to our knowledge, a rigorous assessment of its quality and effectiveness has not been undertaken [21]. The entrance door(s) does not/do not contrast visually with its immediate surroundings. Senior clinician (consultant gynaecologist) involvement in the delivery of acute clinical care has been of interest recently [11], as there is emerging evidence of their positive impact on Emergency Departments (EDs) and Acute Medical Units, contributing to reduced mortality, fewer emergency hospital admissions and accelerated discharge from hospital [1214]. The maximum period staff are allowed to issue a dispensation notice is for 31 calendar days, any requests for dispensation notices for more than 31 calendar days should be sent to the Operations Manager, Property and Transport Services at. If you have abdominal pain inearly pregnancy, we want to ensure that the pain is not caused bya miscarriage or anectopic pregnancy. Planned and actual senior clinician presence, unit size, and weekend opening. The route from the car park to the hospital entrance is not clearly signposted. The results of our study indicate that the presence of senior clinicians in early pregnancy units may not lead to more effective care when this is measured by the proportion of women who are admitted as an emergency. The Pregnancy Sickness Support website has good advice. The soap dispenser cannot be reached from seated on the toilet. There is written text and pictorial signage on or near the toilet door. Resources, Board Meetings (including Agenda and Papers), Corporate publications (Annual Reports and Accounts), COVID vaccine resources for minority ethnic communities, Accelerating care across Lancashire and South Cumbria, Patient Portal: mobile phone appointment letters, Test your equipment for Video Appointments / Calls, Academic Surgical and Perioperative Medicine Unit. Yes As you face the toilet the wall-mounted grab rails are on both sides. BSL interpreters can be provided on request. Walk-in centres can be accessed by anyone and have more flexible opening hours. . Conceptualization, Data Availability: All relevant data are within the papers Supporting information files. Getting To The Hospital This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. The Early Pregnancy Unit is an emergency referral service providing care for women experiencing pregnancy complications, primarily pain or vaginal bleeding, up to 15+6 weeks. We recommend upgrading your browser to continue. The contrast between the walls and floor is good. The shelf is not higher than 95cm (3ft 1in). Site by daysix. The dimensions of the accessible toilet are 212cm x 220cm (6ft 11in x 7ft 3in). Neither planned senior clinician presence (p = 0.874) nor unit volume (p = 0.247) were associated with lower admission rates from EPAU, whilst EPAU opening over the weekend resulted in lower admission rates (p = 0.027). An implantation bleed, when the pregnancy is settling into the womb lining, can be common at around 4-6 weeks. A member of staff is available to assist with opening the door if required. The contrast between the internal door and wall is good. Princess Anne Hospital, Coxford Road, Southampton, Hampshire, SO16 5YA. The Early Pregnancy Unit (EPU) is a walk-in unit open and free of charge to any woman who is . The majority of units (37/44) had a unit volume of less than 4000 visits per year, and 22 units had a yearly visit volume lower than 2500 visits per year. The accessible toilet does not have an unobstructed minimum turning space of 150cm x 150cm in front of the seat. For some analyses, this variable was also dichotomised to indicate whether a unit was open at weekends (yes/no), whilst a three-level weekend opening variable was defined: None/Saturday only/Saturday and Sunday. The unit is open Monday to Friday from 8am-6pm and Sunday 9am-5pm (closed on Saturday). The reception counter is not placed in front of a background which is patterned. Investigation, Continue along Grafton Way and rejoin the A400. In addition, obtaining good quality data on emergency admissions from the Emergency Department based on routine hospital databases proved to be challenging, and we were only able to confidently utilise the data obtained from a fraction of the participating units. There is level access throughout the department/service. Supervision, Units were divided into eight mutually exclusive strata based on these characteristics, and 5 or 6 EPAUs were randomly selected from each stratum to a total of 44 for inclusion in the VESPA study. Language interpreters can be provided on request. At the time of patient recruitment, we collected information about the unit referral policy with regards to the minimum gestational age at which women could be seen at the EPAU. Miscarriage Association, 2023 Northern Ireland Maternity and Parenting. The toilet roll holder is placed higher than 100cm (3ft 3in). Carole Johnston / Nicky Hewitt, Clinical Nurse Specialists for early pregnancy: 01924 541123, Gynaecology assessment unit: 01924 541135, Back to top of page Involvement of senior clinicians in delivering early pregnancy care has no significant impact on emergency hospital admissions for early pregnancy complications. EPAU opening times. Turn right onto Beaumont Place before reaching Warren Street tube station. Your GP can be accessed for a range of non-urgent services. To determine whether the participation of consultant gynaecologists in delivering early pregnancy care results in a lower rate of acute hospital admissions. Contact us. Please do not contact the Early Pregnancy Unit to arrange an appointment with the midwife. EPU is open to talk to or be seen by a nurse from 7.30am to 8pm. Please contact your midwife or maternity triage urgently if your symptoms relate to fetal movement. The dimensions of the designated Blue Badge parking bay(s) surveyed are 410cm x 440cm. The car park does not have a barrier control system. Between the hours of 21:45 and 06:00, when the main entrance is closed, you may use the Maternity entrance situated at the end of the hospital at Glasgow Road. You will have a telephone assessment with a specialist EPAU nurse, and they will advise whether you need to attend a booked appointment for a face-to-face assessment and/orscan. All rights reserved. f) Intrauterine Contraceptive Device in-situ. During patient recruitment, we collected data on the grade of all members of staff present in the EPAU during its opening hours, their involvement in delivering early pregnancy care, as well as the actual hours which each member of staff spent in the unit. My CPD. The contrast between the wall-mounted grab rail(s) and wall is good. There is level access to this accessible toilet. Visualization, WF1 4DG. No, PLOS is a nonprofit 501(c)(3) corporation, #C2354500, based in San Francisco, California, US, Corrections, Expressions of Concern, and Retractions, https://doi.org/10.1371/journal.pone.0260534, https://www.rcog.org.uk/globalassets/documents/guidelines/wprgynstandards2008.pdf, https://www1.health.nsw.gov.au/pds/ActivePDSDocuments/PD2012_022.pdf, https://www.aomrc.org.uk/wpcontent/uploads/2016/05/Seven_Day_Consultant_Present_Care_1212.pdf, https://www.england.nhs.uk/wp-content/uploads/2013/12/evidence-base.pdf, https://www.isdscotland.org/Health-Topics/Quality-Measurement-Framework/Emergency-Admissions/, https://www.kingsfund.org.uk/sites/default/files/Avoiding-Hospital-Admissions-Sarah-Purdy-December2010_0.pdf, https://www.rcog.org.uk/globalassets/documents/careers-and-training/atsms/atsm_acutegynae_curriculum.pdf.