We will also send an electronic copy to your GP. Data curation, Tameside and Glossop Integrated Care NHS Foundation Trust Fountain Street Ashton-under-Lyne OL6 9RW. Writing review & editing, Affiliation All rights reserved. The relationship between emergency admissions from the Emergency Department and senior clinicians presence in EPAU is shown in Fig 4. https://doi.org/10.1371/journal.pone.0260534.g004. Formal analysis, Discover a faster, simpler path to publishing in a high-quality journal. The accessible toilet was out of use at the time of the survey. In view of this, we revised our cut-off and used 2500 instead of 3000 visits to describe the units as high or low volume in the final data analysis. Coping with problems in early pregnancy can be difficult, however unfortunately due to COVID 19 restrictions we are limited to the number of people who can be allowed into the department. Yes Women may self-refer to the Royal Free EPAGU with early pregnancy problems. A hoist can be brought in from another department. The Yellow car park is an underground car park on levels B and C of the Princess Anne Hospital with accessible Blue Badge Bays located on Level C. There are also 21 parent and child bays on level C of the Yellow Car park. There is a/are door(s) into the day room/lounge area. There is sufficient space for a wheelchair user to use the waiting area. There is a payment machine at a convenient height for wheelchair users. My CPD. Your local early pregnancy unit is still available but opening times and appointment availability may have changed. Funding acquisition, If you are based within a GP practice please contact the GPIT Helpdesk on There is not a clear knee recess beneath the low section of the desk. The door(s) is/are double width but one door is locked. Copyright 2023 AccessAble. This accessible toilet is approximately 17m (18yd 1ft) from the clinic entrance. Having collected contemporaneous data documenting the actual time that senior clinicians spent in the EPAU delivering early pregnancy care, we found no significant association whether we analysed for planned or actual presence of the senior clinicians in EPAU. Conceptualization, Language interpreters can be provided on request. This commercial affiliation does not alter our adherence to PLOS ONE policies on sharing data and materials. The Miscarriage Association, Wakefield, United Kingdom, Roles Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom, Affiliations e0260534. The height of the reception desk is high (110cm+). A 1-hour increase in the weekend opening hours of the EPAU was associated with 2.4% (95% CI: 0.1% to 4.7%) lower odds of an emergency admission from the Emergency Department. The height of the intercom is 134cm (4ft 5in). If an appointment is necessary you will be offered a time to attend the unit for an ultrasound scan or to be assessed by the doctor. From the west of the city Southampton General Hospital can be accessed via several routes from the M271. There is not a 120cm hatched zone around the Blue Badge parking bay(s). Both telephone and email applications will be coordinated by the UCH main reception team. The car park does not have a barrier control system. There is/are 7 designated Blue Badge parking bay(s) within the hospital car park. Writing original draft, Elizabeth Garrett Anderson Institute for Womens Health, University College London, London, United Kingdom, Roles Early Pregnancy Assessment Units are highly valued by women but aspects of their care experiences, particularly around sensitive management of pregnancy loss, could be improved. We see women in the first 17 weeks of pregnancy only (up to 14 weeks at Basildon University Hospital). Writing original draft. We have placed cookies on your deviceto help improve our website. You will often be seen at around 6 -7 weeks for a reassurance scan. A key is not required for the accessible toilet. Dispensation notices are issued at the main reception at the UCH site (07.00-20.00 Monday to Friday and 08.00-16.00 on Saturdays, Sundays and Bank Holidays). There is level access into the waiting room / area. The study ran from December 2016 to July 2017. Conceptualization, The nearest National Rail station is Euston. No, Is the Subject Area "Obstetrics and gynecology" applicable to this article? A member of staff is available to assist with opening the door if required. Electronic consent for treatment or a procedure at our hospitals, Nominate a nurse, midwife or clinical support worker for a DAISY Award, New QEII Hospital Community Diagnostic Centre, Patient-initiated follow-up appointments (PIFU), Personalised care follow-ups for cancer patients, To provide high quality, compassionate care. There is level access throughout the department/service. The contrast between the wall-mounted grab rails to the right of the toilet and wall is fair. 9.00am 4.00pm Saturday, Sunday and Bank Holiday (except Christmas Day), 10.00 to 12.00 Sunday and Bank Holiday except 25th December, Clinical assessment if you present with symptoms in early pregnancy, USS scan to assess pregnancy, pelvis, ovaries, Medical/surgical/conservative management for miscarriage orectopic pregnancy, Surgical management of miscarriage under Local anaesthesia (MVA), Outpatient Treatment for hyperemesis (vomiting in early pregnancy), Outpatient treatment for Bartholins abscess, Telephone advise and follow up regarding further investigations, assessment of symptoms and management plans. If you would prefer to contact the Early Pregnancy Unit for information and support, you can contact the Specialist Nursing Team for a consultation between 8:30 am and 5:30 pm, Monday to Friday. The soap dispenser can be reached from seated on the toilet. Opening Hours for patient assessment and care planning. General Practitioner (GP) gpit@camdenccg.nhs.uk to carry out the upgrade. The following buses are used to access the University College Hospital (UCH): Tottenham Court Road - Northbound (Warren Street station) - no's 10, 73, 24, 29, 134. Staff do not need to be notified for use of the lift. The nearest designated Blue Badge parking bay is approximately 25m (27yd 1ft) from the Elizabeth Garrett Anderson Wing main entrance. There is a space for a wheelchair user to manoeuvre. The dimensions of the accessible toilet are 156cm x 241cm. 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. Princess Anne Hospital, Coxford Road, Southampton, Hampshire, SO16 5YA. Elizabeth Garrett Anderson Wing, University College Hospital, 25 Grafton Way, London, WC1E 6DB. Euston Square station has lift access from the platform to the street. Payment machines are located inside the hospital building. Please be aware that some external resources may be restricted to NHS Secure Network connections only. Early Pregnancy Unit and Gynae Assessment Unit is located on Level D of Princess Anne Hospital. The early pregnancy and acute gynaecology unit (EPAGU) at Queen Charlottes & Chelsea Hospital is internationally recognised for expertise in early pregnancy and gynaecology ultrasound scanning. Funding acquisition, Is the Subject Area "Pregnancy" applicable to this article? We provide a dedicated service to women under 16 weeks gestation. Resources, To keep our patients safe, we are currently offering a telphone advice, triage and referral service. There is not a Patient Advice and Liaison Service (PALS) at the hospital. Warren Street (Northern / Victoria Lines) and Euston Square (Circle / Hammersmith & City / Metropolitan Lines) are the closest tube stations to University College Hospital (UCH). As a result, we have been appointed by the Tommys charity as the Tommys National Centre for Miscarriage Research in collaboration with the University of Birmingham and the University of Warwick. There is not a/are not door(s) into the waiting room / area. Methodology, The maternity unit is situated on the second floor of the hospital (level2). View our cookie policy. The distance between the floor and the highest table is 43cm (1ft 5in). You should still contact the Early Pregnancy Unit on the phone number below, which will inform you of where to call in the event of an emergency. If a scan is required and where it cannot be performed on the same day we will do our best to ensure that any wait is as short as it can be and we will endeavour to keep you updated of any delays. The height of the wash basin is 86cm (2ft 10in). If you experience vaginal bleeding and/or abdominal pain you can be seen for assessment up to 19+6 weeks gestation. Data curation, Elizabeth Garrett Anderson Wing (EGA) is not located within the congestion zone. There is a/are door(s) leading into the department/service. To determine whether the participation of consultant gynaecologists in delivering early pregnancy care results in a lower rate of acute hospital admissions. Yes The toilet roll holder is placed higher than 100cm (3ft 3in). View on a map. The unit is open Monday to Friday from 7.30am-8pm with scanning facilities from 9am-5pm, and Saturday 9am-5pm (closed on Sunday). Visit the Miscarriage Association website which has a wide range of information as well as the different ways you can access support. These associations did not markedly change after further confounder adjustment. The height of the towel dispenser is 106cm (3ft 6in). If you are unable to book an appointment, or need to see a GP out of hours, call your surgery and follow the advice provided. Warren Street (bus stop W) no's 18 and 205. There is a dropdown rail on the transfer side. The main door(s) open(s) towards you (pull). The hospital does have a dedicated car park. 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 These data were collected retrospectively at the end of the three-month period corresponding to the date when the last woman recruited to the cohort study was discharged from each hospitals EPAU. on the right to withdraw consent, can be found in the website's privacy policy. Models were either unadjusted or adjusted for gestational age unit policy. There is an/are accessible toilet(s) within this venue designated for public use. Where possible units will try to give you fluid and anti-sickness medication as a day patient to avoid you having to stay in hospital where possible. This was due to the changes in provision of medical cover which occurred between the site initiation visit and the start of recruitment. The post code for the Sat-nav is SO16 5YA. The name / number of the room surveyed was; 3. Yes Whilst the majority of pregnancies will progress without complications, many women experience problems that they feel they would like support or further information for. The unit has excellent links with the fetal medicine service, also based at Queen Charlottes. In some miscarriages the uterus (womb) empties itself completely. You can contact the service by calling 01279 827107. People who still have an ongoing pregnancy will be discharged back to the care of their midwife. a new pregnancy and under the care of the recurrent miscarriage clinic. Current constraints on health expenditure have compelled providers to explore ways of delivering a greater proportion of care in outpatient settings whilst maintaining good clinical outcomes and high levels of patient satisfaction. Clinic 24 is a small, but busy, unit based on Level 1 in the Rosie. The height of the towel dispenser is 125cm (4ft 1in). There is not a flashing fire alarm beacon within the waiting room / area. This involves clinical review, investigations,diagnosis and treatment on the same day. There is not a hearing assistance system. There is ramped/sloped access at this entrance. If necessary, patients can be admitted under the on-call gynaecology team 24 hours a day, seven days a week. There is a/are clinical waste disposal units. Writing review & editing, Affiliation There is a Patient Advice and Liaison Service (PALS) at the hospital. It is likely that they will be unable to offer reassurance scans if you have experienced previous early pregnancy problems unless you have symptoms in this pregnancy but individual units availability may vary. The percentage of emergency admissions from the Emergency Department ranged from 7% to 58% with the majority of the units having an emergency admission rate of between 10% and 30%. Calls will be answered whenever possible but a voicemail facility will also be in place for times when the phone cannot be answered, including out of hours. This is based on 6397 women that had complete information on the outcome and key characteristics. Formal analysis, Payment signs are located at the payment machines in the hospital building. The mirror is not placed at a lower level or at an angle for ease of use. We listen to patient feedbackto deliver patient-centred care. 205/6397 (3.2%; 95% CI 2.83.7) women were admitted following their EPAU attendance. Conceptualization, Turn left as you pass through the doors and continue ahead. 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. There is clear signage on the department/service. The IHE does not currently receive funds for research related to the submitted work. Sexual health, contraception and HIV services, Vaginal bleeding and/or pain in early pregnancy up to 16 weeks, A loss of liquor before 16 weeks (watery vaginal loss), A positive pregnancy test and ascanresult showinga pregnancy of unknown location with pain, bleeding or other relevant symptoms, A previous ectopic pregnancy (at sixweeks gestation they can be referred for a scan). The towel dispenser is placed higher than 100cm (3ft 3in). 1445/5464 (26.4%; 95%CI 25.3 to 27.6) women were admitted from ED. The Early Pregnancy Assessment Unit (EPAU) provides care and support to women and anyone experiencing complications in early pregnancy, as well as their partners. The Patient Advice and Liaison Service (PALS) is located on the ground floor of the main University College Hospital building. 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. The contrast between the wall-mounted grab rails to the left of the toilet and wall is poor. We would like to thank Ms Heidi Chandler; whose hard work and dedication was instrumental in securing the funding for this study. It is not intended for public use. We collected data about the total number of Emergency Department attendances and emergency in-patient admissions of women who presented with first trimester pregnancy complications. Treatments available for miscarriage include natural management, medical management, daysurgical management under local anaesthetic (MVA) and surgical management treatment under general anaesthetic. Study participants will not be individually informed of the study results; however, dissemination to the public will be through media outreach (e.g., press release) upon publication of this study. There is not a/are not Blue Badge parking bay(s) available. There is not a mirror to aid reversing out of the lift. e) three or more previous miscarriages There are not separate entry and exit doors in the lift. Send email. Pregnancy sickness or morning sickness can be debilitating and difficult in the early stages of pregnancy. Planned senior clinician presence was defined as the percentage of planned hours which they were expected to spend in the unit according to their weekly timetable, divided by the planned unit opening hours. Monday to Sunday 08:00 to 13:00. There is written text and pictorial signage on or near the toilet door. There is sufficient space to write or sign documents on the desk. There is/are 10 designated Blue Badge parking bay(s) within the hospital car park. When we compared actual with planned senior clinicians presence, we found that in only 3/19 units (16%) did senior clinicians spend more than 15% of their time actively delivering clinical care, and in 13/19 units (68%) their actual documented presence was less than 5%. Our findings are in contrast with the results of previous studies in other clinical settings, which showed that involvement of more experienced clinicians in delivering emergency care results in a significant reduction in emergency hospital admissions and the length of stay in hospital [12, 18]. Return to maternity and newborn services home, View our current vacancies and read about working with us, Read about our Media service and Communications Team, you are in significant pain despite simple pain killers such as Paracetamol, experiencing moderate to severe vaginal bleeding. Visit website. The accessible toilet does not have an unobstructed minimum turning space of 150cm x 150cm. Find your hospital ward contact information: This service runs across two sites at Queen Charlottes & Chelsea Hospital and St Marys Hospital. We obtained clinical data from 6,606 women. Outside of clinic opening hours, patients are triaged in A&E and can be offered gynaecological assessment and ultrasound if an urgent clinical . on the right to withdraw consent, can be found in the website's privacy policy. Women may also be referred to the units if they are pregnant and have a previous history of miscarriage or ectopic pregnancy, or if there is a suspected gynaecological problem that requires urgent clinical assessment. The nearest standard toilets are located on the ground floor of the Elizabeth Garrett Anderson Wing. For service contact details please visit the relevant service page. We may be able to offer an immediate appointment for those walking in, but if not, women will be asked to attend A&E or return at a later date or time. If counselling is required then people are signposted to Charlies Angels for further support. Research that could potentially guide recommendations and policies on staffing and configurations of EPAUs has been scarce [69]. Methodology, The dropped kerb does not have tactile paving. Due to the current Covid-19 restrictions, we ask that you do not bring childrento your appointment. Assistance may be required because there is/are uneven surfaces. This link takes you to the University College Hospital (UCH) page with information on travelling to the hospital. 020 3456 7890. Methodology, The ramp/slope is located in front of the entrance. Pregnancy Sickness Support website, here. Access to the building between 21:00 - 07:00 is via intercom. Roles On the UCH site, security staff, at the security desk in the UCH Atrium and at the Elizabeth Garrett Anderson Hospital EGAH reception are able to issue dispensation notices out of hours. Methodology, Department of Statistical Science, University College London, London, United Kingdom, Roles Access to the hospital is either by following the pedestrian marked path around the hospital building or via a very narrow spiral staircase. Resources, There is dedicated team of trained sonographers and consultants who provide the ultrasound services. Planned and actual senior clinician presence, unit size, and weekend opening. It is also unclear whether completion of the module is a requirement locally for appointment to EPAU leadership roles. PLOS ONE promises fair, rigorous peer review, Accident and Emergency Department/999 This avoids the need for patients/carers to park illegally on the day while they come in to get their dispensation notice. All rights reserved. Where applicable, participants gave informed written consent before taking part in the study. If it is decided that you need outpatient care,the Emergency Department will send an electronic referral to the EPAU nurse, and you will be contacted either the same dayor the next working day. The car park does not have a height restriction barrier. . Parking spaces for Blue Badge holders do not need to be booked in advance. The unit has strong international links, in particular with KU Leuven in Belgium.