Data curation, t: 020 7794 0500 ext 38205 or 31468. Discover a faster, simpler path to publishing in a high-quality journal. Visualization, This venue does not play background music. Theyprovide a range of services such as peer support and counselling services. The dedicated staff are sensitive and committed to supporting the emotional needs of women and couples requiring this service. Gower Street - Southbound (University Street) - no's 10, 24, 29, 73, 134. No, Is the Subject Area "Hospitals" applicable to this article? It is not intended for public use. 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. Methodology, During working hours, women needing EPAGU services who attend A&E will be sent directly to the unit. There are not separate entry and exit doors in the lift. Validation, 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. Jeff Round reports grants from NIHR, during the conduct of the study; and Dr Round is currently employed by the Insitute of Health Economics (IHE). EPAU is a specialist unit that manages early pregnancy problems such as vaginal bleeding and abdominal pain. Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom, There is a clear unobstructed route to the reception point. Keeping an EPAU open over the weekend for an additional hour was associated with 2.4% (95% CI 0.1% to 4.7%) lower odds of an emergency admission from ED. Conceptualization, The other possibility is that senior clinicians, who are fully trained in general obstetrics and gynaecology, lack the additional clinical and ultrasound skills necessary for the effective running of an EPAU. 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). Where applicable, participants gave informed written consent before taking part in the study. There is step free access to Early Pregnancy Unit and Gynae Assessment Unit. The funder provided support in the form of salaries for authors MM, VG, GA, PB, EK, SS, ZA, JR, NK, JH, GB, JS, DJ; however, the funder and sponsors of the study did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. We received input from patients who had experienced first trimester pregnancy complications in the design and timing of the study materials, and management oversight through membership of the study steering committee. EPU and UGCC | NHS Frimley Health Foundation Trust Funding acquisition, If you have a non-urgent concern not related to your pregnancy such as chest/urine/ear infections, skin complaints, viral infections, exposure to infections i.e chickenpox, you should see your GP for advice as they are better placed to help with these problems. The toilet roll holder is placed higher than 100cm (3ft 3in). Research that could potentially guide recommendations and policies on staffing and configurations of EPAUs has been scarce [69]. These associations did not markedly change after further confounder adjustment. King's College Hospital Early Pregnancy Assessment Unit (EPAU) Address: Suite 8, Third Floor Golden Jubilee Wing Denmark Hill London SE5 9RS Telephone: 0203 299 3168 Usual Opening Times Location Map Get Directions This is a walk in service so you need no appointment, simply attend the unit. In some cases additional treatment is needed such as: An early pregnancy loss can be a deeply distressing experience both physically and emotionally and we want to ensure that you are able to access the support you need during this difficult time. King's College Hospital Early Pregnancy Assessment Unit (EPAU) Copyright 2023 East and North Hertfordshire NHS Trust. We could therefore calculate the actual amount of time senior clinicians spent in EPAU delivering clinical care. There is level access throughout the department/service. People can self-refer to the unit by contacting 01924 541135 or through their GP, midwife, hospital doctor, Emergency Department staff if they have: Once you have been referred you will be contacted by a member of staff who will initially offer a triage assessment over the phone. Involvement of senior clinicians in delivering early pregnancy care has no significant impact on emergency hospital admissions for early pregnancy complications. The entrance area/door is clearly signed with the name of the service/department. The lighting levels at the reception point are good. The room does not have background music playing. Language interpreters can be provided on request. Copyright: 2021 Memtsa et al. EPAU opening times | Wirral University Hospital NHS Foundation Trust There is not an assistance dog toilet or toileting area on the hospital site. You are accessing this website using a legacy browser. The hospital entrance is not clearly visible from the car park. Visit website. After yourscan, you will be reviewed by one of the specialist nurses who will then discuss with you the likely cause of your symptoms, whether you need to have any more investigations, and your treatment options. Search for local Pregnancy near you on Yell. There is not a hearing assistance system. There are strong links with the Institute of Reproductive and Developmental Biology (IRDB) at Imperial College London run by Professor Phillip Bennett, with projects ranging from the study of the microbiome to novel biomarkers in early pregnancy. A summary of all units showing their characteristics in respect to the key factors of interest and outlining participants median age, parity, deprivation score, ethnicity and gestational age at presentation is provided in Table 1. The lift does have a visual floor indicator. The dimensions of the designated Blue Badge parking bay(s) surveyed are 410cm x 440cm. Volunteers do not receive disability awareness / equality training. Investigation, Methodology, Referrals are either from GP or the emergency department. If you are not under the care of the EPAU, please contact your GP. This avoids the need for patients/carers to park illegally on the day while they come in to get their dispensation notice. EPAUs are currently operating in most acute hospital units in the UK aiming to provide women with comprehensive early pregnancy care, which includes clinical and ultrasound assessment, laboratory investigations, further management, as well as counselling and support, all in an out-patient setting. The alarm was out of reach (higher than 10cm (4") from floor) when surveyed. Please complete the form calledEarly Pregnancy Assessment Unit (EPAU) and email to: GP to telephone to make an appointment Two sets were used because IMD and gestational age policy had a reasonable amount of missing data. On arrivalyou will be booked in by our dedicated admin clerk anddirected to the EPAU waiting area with your referral form and a number. In some miscarriages the uterus (womb) empties itself completely. on the right to withdraw consent, can be found in the website's privacy policy. 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. Do not wait to be called by the EPAU team. The reception area/desk is approximately 6m (6yd 1ft) from the clinic entrance. The role of the commercial company MASS Ltd, as an elite researcher in workforce modelling, was advisory with regards to data collection and analysis. There was little evidence of an association with planned senior clinician time (p = 0.280) or unit volume (p = 0.647). There is/are 10 designated Blue Badge parking bay(s) within the hospital car park. Methodology, The email address for the Patient Advice and Liaison Service (PALS) is. The IHE receives funding from, and collaborates with, government, academic, not-for-profit and private sector organisations. 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. The aim was to capture hospital emergency activity with regards to early pregnancy care in EDs. View Article PubMed/NCBI . Early Pregnancy Unit and Gynae Assessment Unit is located on Level D of Princess Anne Hospital. There is a level turning space (minimum 185cm x 210cm) in front of the payment machine(s). The early pregnancy and acute gynaecology unit (EPAGU) at Queen Charlotte's & Chelsea Hospital is internationally recognised for expertise in early pregnancy and gynaecology ultrasound scanning. A to Z of services | Croydon Health Services NHS Trust Non-urgent referrals seen on the same or next day. The dimensions of the accessible toilet are 156cm x 241cm. For the emergency hospital care audit strand, data from routine hospital databases for women attending hospital emergency services (EDs) at the same location as the EPAU were collected in collaboration with the Information Services (IS) departments in the participating hospitals. They will be asked to sign a declaration form and wait for you outside the department until you are called in for your scan. This variable was also dichotomised for some analyses to indicate whether the annual number of patient visits for a unit was above or below the median. The car park does not have a barrier control system. Writing original draft, The route from the car park to the hospital entrance is not clearly signposted. We provide high quality healthcare services primarily to the residents of East Lancashire and Blackburn with Darwen, which have a combined population in the region of 530,000. We would advise you attend your local emergency department unitif bleeding worsens whereby you are having to change your sanitary pad more frequently and feel unwell, or ifyou are experiencing severe abdominal pain which is not improving with simple pain relief egparacetamol. Funding acquisition, All rights reserved. The height of the toilet seat above floor level is 48cm (1ft 7in). An Early Pregnancy Unit in the United States: An Effective Method for Evaluating First-Trimester Pregnancy Complications. This video animation tells the story of one couples experience of miscarriage. There is level access to this accessible toilet. There is a horizontal wall-mounted grab rail on the opposite side of the seat to the transfer space. The soap dispenser cannot be reached from seated on the toilet. 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. 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. The car park surface is a shared surface. For many people who experience miscarriage it isnt just a physical loss, but the loss of hopes and dreams for the future. Methodology, Modelling and Analytical Systems Solutions (MASS) Ltd, Edinburgh, United Kingdom, Roles There is step-free access to the accessible toilet. If your GP is closed you can access the out of hours GP services. Validation, We would like to thank Ms Heidi Chandler; whose hard work and dedication was instrumental in securing the funding for this study. The height of the soap dispenser is 99cm. You can do this by calling theCentral Booking Line on 01282 804512 (available 9am - 12pm, Monday - Friday). Elizabeth Garrett Anderson Institute for Womens Health, University College London, London, United Kingdom, Roles There is some flooring in the department/service which is shiny and could cause issues with glare or look slippery to some people. If you do not wish to have them in the room during your appointment, please let the nurse or doctor know and students can be asked to step outside. Copyright 2023 AccessAble. Contact details will be put on all outpatient letters. The NICE guideline developing group, which includes a patient and public involvement panel, concluded that the configuration of services between different units varied considerably but, due to paucity of data, they were unable to make recommendations on the optimal structure of EPAUs that would balance clinical and service outcomes against cost-effectiveness. There is not a red flashing fire alarm beacon within the toilet. The Pregnancy Sickness Support website has good advice. The reception counter is not placed in front of a background which is patterned. A moderate level of clustering within units (Intraclass Correlation Coefficient, ICC = 0.04) was assumed. Data Availability: All relevant data are within the papers Supporting information files. https://doi.org/10.1371/journal.pone.0260534, Editor: Gang Qin, Nantong University, CHINA, Received: April 5, 2021; Accepted: November 11, 2021; Published: November 30, 2021. They can also be obtained from UCH Macmillan Cancer Centre Site Main Ground Floor Reception (08.00-20.00 Monday to Friday only). Both telephone and email applications will be coordinated by the UCH main reception team. This was due to the changes in provision of medical cover which occurred between the site initiation visit and the start of recruitment. Many of our studies are currently recruiting and women attending the EPAGU will be invited to participate. f) Intrauterine Contraceptive Device in-situ. This commercial affiliation does not alter our adherence to PLOS ONE policies on sharing data and materials. The Early Pregnancy Unit (EPU) provides a wide range of services for women who are experiencing concerns in early pregnancy. The Early Pregnancy Unit runs in parallel with the Gynaecology Assessment Unit (GAU) and provides services for women with complications of pregnancy such as pain or bleeding up to 16+6 weeks gestation. Writing review & editing, Roles For more information please contact Professor Tom Bourne, consultant gynaecologist by emailing t.bourne@ic.ac.uk at Queen Charlottes, or Dr Shahla Ahmed, consultant gynaecologist by emailing shahla.ahmed1@nhs.net at St Marys. The sonography team will advise if you need to empty your bladder prior to the scan. The Early Pregnancy Assessment Unit (EPAU) in Ward C1 at the University Hospital of Wales is an integrated single unit, which takes referrals from all overCardiffand the Vale of Glamorgan. Women with nausea and vomiting in pregnancy should contact their GP for an assessment of their symptoms to exclude other causes for nausea and vomiting in pregnancy such as urinary tract infections. View photos. This accessible toilet is located to the right as you pass through the waiting area. North Central London GP Website. 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. Occasionally, for both early pregnancyand emergency gynaecology you may need to be admitted into hospital for us to perform further investigations,monitor you, or initiate treatment but we will keep you informed of this and support you through this process. Prior to unit recruitment, a national survey was distributed to all 212 EPAUs operating in UK NHS hospitals between 2015 and 2016. The width of the accessible toilet opening is 84cm. Recurrent pregnancy loss Natural management: Many people are able to return home after their scan where their miscarriage will complete naturally. The association between the three factors: senior clinician presence, unit volume, and weekend opening hours, and the proportion of emergency admissions was investigated by using regression models, where hierarchical models were used for analysing patient-level data, and standard models were used for analysing unit-level data. We obtained similar results whether we analysed for senior clinician presence as a binary outcome or as a continuum. The controls for the lift are within 90cm - 120cm from the floor. Investigation, Access to Early Pregnancy Unit and Gynae Assessment Unit is via the Level D entrance. Department of Statistical Science, University College London, London, United Kingdom, Roles The width of the door opening is 87cm (2ft 10in). The floors which are accessible by stairs are B-LG-G-1-2. 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 . You must telephone the unit before attending we do not run a walk-in clinic or service. Conceptualization, Monday to Friday 8.30am - 4.30pm (excluding Bank Holidays). You can catch the Bluestar 17 and City Red Three buses from the station - both continue to Southampton General Hospital and Princess Anne Hospital. If you are having a problem in early pregnancy, your first contact should be with your GP, or the out-of-hours service when your GP surgery is closed. You can visit a walk in centre for any general illness or concern for which you may have visited your GP. Due to the current Covid-19 restrictions, we ask that you do not bring childrento your appointment. Clinic 3 - Early Pregnancy Unit | AccessAble The reception area/desk is clearly visible from the entrance. 205/6397 (3.2%; 95% CI 2.83.7) women were admitted following their EPAU attendance. Telephone: 0161 922 6000 There is/are 7 designated Blue Badge parking bay(s) within the hospital car park. The accessible toilet does not have an unobstructed minimum turning space of 150cm x 150cm. The main car park for the Princess Anne Hospital is called the Yellow car park. The width of the accessible toilet door is 87cm (2ft 10in). The Early Pregnancy Unit (EPU) is a walk-in unit open and free of charge to any woman who is . In the submitted paper, there are no competing interests and MASS has no claim of ownership for any IP arising from or related to this paper. 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. This maynot always possible depending on service demand and the type of investigation, monitoring or treatment you may need. The Unit is open at all times. This department/service has; a main reception, accessible toilet facilities for everyone, ambulant toilet facilities for everyone, consultation rooms, standard toilet facilities and a waiting room/area. A total of 205/6397 (3.2%; 95% CI 2.83.7) women were admitted following their EPAU attendance. They were established following a publication by Bigrigg and Read [5] in 1991 who reported on cost savings and improved quality of early pregnancy care following the opening of an EPAU in their local hospital. When you attend an early pregnancy appointment you can bring one adult support partner with you however no children are currently able to attend with you. Getting To The Hospital The tube stations are located at opposite ends of the hospital main building. You can find more information about these on the patient information page. Tommys Tommy's is a charity that funds research for pregnancy and babies. The EPAU is a specialist unit that manages early pregnancy problems such as vaginal bleeding and abdominal pain. 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 toilet roll holder can be reached from seated on the toilet. Sergio A. Silverio (Kings College London) is supported by the National Institute for Health Research Applied Research Collaboration South London [NIHR ARC South London] at Kings College Hospital NHS Foundation Trust. There is pictorial signage on or near the toilet door. Elizabeth Garrett Anderson Wing, University College Hospital, 25 Grafton Way, London, WC1E 6DB. This information is for the entrance located on Grafton Way. Wakefield GAU is a 24 hour service and can offer advice and . There is not a/are not Blue Badge parking bay(s) available. If you are experiencing heavy bleeding and/or severe pain, or feeling dizzy, please go straight to the Emergency Department. Find your hospital ward contact information: This service runs across two sites at Queen Charlottes & Chelsea Hospital and St Marys Hospital. Supervision, This technique was adopted to ensure that units of all configurations were equally represented in the final sample. There is not a flashing fire alarm beacon within the waiting room / area. Get contact details, videos, photos, opening times and map directions. A total of 205 EPAUs which completed the survey reported on unit location, opening hours, access to services, and staffing configurations. The wash basin cannot be reached from seated on the toilet. Methodology, 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. There is room for a wheelchair user to manoeuvre. There is sufficient space for a wheelchair user to manoeuvre within the imaging room. The drop off bays are on the side of the access road to the car park and there are no kerbs. Methodology, If required emergency surgery can be performed, or women may be monitored and appropriate follow up arrangements made. Twenty-three units were open during weekends. The service is then located on the right. The towel dispenser is placed higher than 100cm (3ft 3in). The floors which are accessible by this lift are B-LG-G-1-2. 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. We see people who: are in the early stages of their pregnancy (up to 18 weeks) have acute gynaecological problems needing urgent support We provide: same day emergency care urgent planned appointments support during the first 18 weeks of pregnancy The bollard(s) has/have a good colour contrast to prevent them being hazardous to visually impaired people. By clicking any link on this page you are giving your consent for us to set cookies. Gynaecology Outpatient Department,Ground floor, Green Zone, Lewisham High Road, SE13, Gynaecology Outpatients Department, Stadium Road, Greenwich, London SE18 4QH. 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. Ultrasound based assessment for suspected pelvic pathology. You can contact the service by calling 01279 827107. Resources, It has been created to raise awareness and help others to see that what they are going through is completely normal. Take the lift to the lower ground floor and on exiting turn right and go through the double doors. Get contact details, videos, photos, opening times and map directions. This variable was also dichotomised for some analyses to indicate whether they were expected to spend any time in EPAU (yes/no). See below link for maternity web page if need more information needed regarding these concerns. Yes Methodology, Report a problem or suggestion using this facility. There are no chairs with armrests available. The towel dispenser is placed higher than 100cm (3ft 3in). There is a payment machine at a convenient height for wheelchair users. Early Pregnancy Assessment Unit - Betsi Cadwaladr University Health Board There is a/are door(s) into the consultation / treatment room. here. Wherever possible, all data relating to hospital admissions provided by the IS departments were crosschecked by a member of the research team against ward admission books/databases in an attempt to check their accuracy. https://doi.org/10.1371/journal.pone.0260534.s001, https://doi.org/10.1371/journal.pone.0260534.s002. This accessible toilet is approximately 15m (16yd 1ft) from the clinic entrance. The mirror is not placed at a lower level or at an angle for ease of use. Our study has several limitations. They are organisational structures which operate in most acute hospitals in the UK and an increasing number of other countries worldwide [14]. 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. Your local early pregnancy unit is still available but opening times and appointment availability may have changed. There is step free access to the reception point. The contrast between the walls and floor is good. The route from the car park to the hospital entrance is not clearly signposted. 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. Writing original draft, The name / number of the room surveyed was; 3. You may find that certain parts of the Accident and emergency patient information leaflets, Video consultations - frequently asked questions, Visiting and keeping in touch during Covid-19, Log in or register with Patients Know Best, Patients Know Best - frequently asked questions, Patients Know Best and NHS App integration, Yorkshire Regional Spinal Injuries Centre (YRSIC), Psychology department - Every Voice Matters, Complex Eating, Weight and Bariatric Psychology, Plastic, Reconstructive and Burns Surgery, Breast plastic and reconstructive surgery, Skin cancer plastic and reconstructive surgery, Trauma plastic, reconstructive and burns surgery, Population and people who use our services, Zero Tolerance - Abuse is not in a day's work, Genetic Links to Anxiety and Depression (GLAD) study, Providing Online guided Self-help for Eating disorders in adults with type 2 Diabetes (POSE-D) pilot study, General Data Protection Regulation (GDPR), Safe Nursing and Midwifery staffing levels, Medical Education & Simulation Hub (MESH), Visit the Miscarriage Association website, previous ectopic or molar pregnancy with a new pregnancy.
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