TRANSITION OF CARE PROTOCOL FROM EMERGENCY DEPARTMENT TO STONE CLINIC IMPROVES NON-OPERATIVE MANAGEMENT

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INTRODUCTION

Patients in distress are less likely to attempt ureteral stone passage. We introduced a standardized transition of care protocol from Emergency Department to stone clinic in attempt to improve patient status at time of consultation and report outcomes over time.

METHODS

All patients referred to subspecialty stone clinic were identified. A standardized transition of care protocol was developed and promoted. The protocol included: subspecialty stone clinic referral; patient discharge instruction emphasizing non-narcotic symptom control; a next-day stone clinic nurse triage call; and expedited clinic access. Shared decision-making regarding trial of stone passage occurred at initial clinic encounter. PROMISĀ® pain intensity was recorded preceding provider contact (score of 60 represents 1 standard deviation above population mean). Inclusion criteria: uninfected, unilateral,