An Early Pregnancy Unit in the United States: An Effective Method for Evaluating First-Trimester Pregnancy Complications. There is level access to the consultation / treatment room. As you face the toilet the wall-mounted grab rail(s) is/are on both sides. We chose to study the rate of emergency admissions which is a recognised quality outcome indicator for acute hospital units [19, 20]. The width of the door opening is 86cm (2ft 10in). Contact details for early pregnancy services for your Trust can be found on the homepage. The dropped kerb does not have tactile paving. After 18 weeks, the patient is seen in the Emergency Obstetric Unit or Delivery Suite. Unit volume was defined as the number of patient visits per year and was estimated using the time taken to obtain data on the required number of patients and the average number of visits per patient. Princess Anne Hospital, Coxford Road, Southampton, Hampshire, SO16 5YA. www.ectopic.org.ukSupporting people who have experienced an early pregnancy complication. The drop-off point is located on Beaumont Place. Copyright 2023 AccessAble. Elizabeth Garrett Anderson Institute for Womens Health, University College London, London, United Kingdom, In total, 1,445/5,464 (26.4%; 95%CI 25.3 to 27.6) patients had an emergency admission from the Emergency Department. Writing review & editing, Affiliation This venue does not play background music. Yes Carole Johnston / Nicky Hewitt, Clinical Nurse Specialists for early pregnancy: 01924 541123, Gynaecology assessment unit: 01924 541135, Back to top of page Aberford Road 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. There is written text and pictorial signage on or near the toilet door. On your first visit to UCH or the UCH Macmillan Cancer Centre you need to park your car and bring the following to the reception desk - your valid Blue Badge, your vehicle registration document or Motability documents, proof of hospital attendance, showing appointment time and date e.g. Fitting multivariable logistic models, we found an association between the emergency admissions from the Emergency Department and weekend opening (p = 0.037). We also accept GP referrals for emergency gynaecology problems. The contrast between the walls and floor is good. We ask that they call the unit so that we can book them a timed appointment. The toilet roll holder is placed higher than 100cm (3ft 3in). All rights reserved. The lift is approximately 24m (26yd 9in) from the Elizabeth Garrett Anderson Wing main entrance. As it is not necessary for UCH staff to see the Blue Badge at the time of issuing a dispensation notice, a notice can be issued in advance and posted or emailed to patients. Wakefield This room is not accessed via a changing room. The dimensions of the accessible toilet are 210cm x 220cm (6ft 11in x 7ft 3in). 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 width of the accessible toilet opening is 84cm. The contrast between the dropdown rail(s) and wall is good. GAU is a 24 hour service and can offer advice and . Hospital staff do not receive disability awareness / equality training. The toilet roll holder can be reached from seated on the toilet. View Accessibility Symbols. The Pregnancy Sickness Support website has good advice. 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. 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. Natural management: Many people are able to return home after their scan where their miscarriage will complete naturally. We provide a dedicated service to women under 16 weeks gestation. 023 8077 7222. A hearing assistance system is not available in the department/service. Always inform the staff in the department you are pregnant. There is step free access at this entrance. Your local early pregnancy unit will be able to advise you as to whether your symptoms warrant an urgent or emergency appointment. Yes, however bleeding does not necessarily mean there is a problem. The main door(s) open(s) towards you (pull). We found that, in general, the actual amount of time spent by the senior clinicians in the units was less than planned, and in only five units, they were present for more than 5% of the time (Fig 3). There is sufficient space next to the bed/couch for a mobile hoist to operate. The route from the car park to the hospital entrance is not clearly signposted. There is a/are manual, heavy, double door(s) between the lift and the department/service. GP EPAU referral form [docx] 99KB (click to download). The contrast between the external door and wall is good. There is not a Patient Advice and Liaison Service (PALS) at the hospital. Early Pregnancy Unit and Gynae Assessment Unit is approximately 14m from the Level D entrance. . There is not an assistance dog toilet or toileting area on the hospital site. The car park does have a height restriction barrier. We have a dedicated gynaecology team of doctors and nurse practitioners to care for you and to make a full assessment of your symptoms. There is a dark mat or floor marking at this entrance that might be perceived as a hole. Resources, 020 3688 1881 or email 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. Outside of clinic opening hours, patients are triaged in A&E and can be offered gynaecological assessment and ultrasound if an urgent clinical . This information is for the entrance located on Grafton Way. Writing review & editing, Affiliation This showed substantial variations in the proportion of in-patient emergency admissions with 8.5% in units without, and 3.5% in those with, senior clinician presence. There are parking charges for the hospital car park. When you attend an event booked through the North Central London GP Website, Opening Times (Early Pregnancy Unit and Gynae Assessment Unit) Department / Service (Early Pregnancy Unit and Gynae Assessment Unit) Reception Consultation / Treatment Room (3) Imaging Room Day Room / Lounge Area (Quiet Room) Accessible Toilet (s) Related Access Guides Getting To The Hospital (Princess Anne Hospital) Collapse all By Road View 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. During the day you can access the maternity unit by entering the hospital through the main entrance. Get contact details, videos, photos, opening times and map directions. As part of this assessment, they may ask for investigations that may be performed on the same day or within urgent time frames and a management plan will be made for you. The relationship between emergency admissions from Emergency Departments and senior clinician presence, unit volume, and weekend opening hours was investigated by fitting multivariable logistic regression models. If you have abdominal pain inearly pregnancy, we want to ensure that the pain is not caused bya miscarriage or anectopic pregnancy. 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. Standard manual wheelchairs are available for people to borrow at this entrance. Conceptualization, There is not a hearing assistance system. The towel dispenser is placed higher than 100cm (3ft 3in). The Early Pregnancy Assessment Unit (EPAU) provides care and support to women and anyone experiencing complications in early pregnancy, as well as their partners. Women may self-refer to the Barnet EPAGU only if they have had a previous ectopic pregnancy or recurrent miscarriages. Yes 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. There are volunteers available for help and assistance at the hospital. This was due to the changes in provision of medical cover which occurred between the site initiation visit and the start of recruitment. We are now welcoming self referrals from women,however, we will still accept referrals from the existing pathway. The post code for the Sat-nav is SO16 5YA. The contrast between the external door and wall is good. 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. From the west of the city Southampton General Hospital can be accessed via several routes from the M271. The variable Emergency admission indicates whether a patient had an unplanned admission to hospital following any visit for investigations or treatment of first trimester pregnancy complications. The emergency pull cord alarm is not fully functional. The lighting levels in the imaging room are low to moderate. In the UK, the care of women experiencing complications in the first trimester of pregnancy is mainly provided in Early Pregnancy Assessment Units (EPAUs). The entrance area/door is not clearly signed. Data Availability: All relevant data are within the papers Supporting information files. Your local early pregnancy unit is still available but opening times and appointment availability may have changed. The lateral transfer space is 170cm (5ft 7in). There is dedicated team of trained sonographers and consultants who provide the ultrasound services. Yes A total of 205 EPAUs which completed the survey reported on unit location, opening hours, access to services, and staffing configurations. 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. 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. The title of this entry will be Early Pregnancy Assessment & Gynaecology Unit: RFL. The EPAU is a specialist unit that manages early pregnancy problems such as vaginal bleeding and abdominal pain. EPU is open to talk to or be seen by a nurse from 7.30am to 8pm. Access to the University College Hospital (UCH) is via the A400, turning right onto Grafton Way. As our hospitals are teaching hospitals, medical or midwifery students may be present during your appointment. Possible symptoms include: Bleeding The transfer space is obstructed by a waste disposal bin. Both provide consultant-led care for women who experience problems in early pregnancy. 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. Funding: The VESPA study received funding from the NIHR Health Services & Delivery Research (HS&DR) programme grant number 14/04/41. Barnet Hospital also offers a walk-in service. Access to the building between 21:00 - 07:00 is via intercom. EPAU is located on Level 2, Area 7, Burnley General Teaching Hospital. new North Central London GP Website do not work as expected. Planned and actual senior clinician presence, unit size, and weekend opening. If you are under 5 weeks of pregnancy it may be more suitable to contact your GP for further advice and support. Opening Times. Formal analysis, When you attend the Emergency Department, you will be assessed by a doctor to see whether you need to stay in hospital and receive care as an inpatient, or whether you can be discharged and referred to to the EPAU as an outpatient. Scan is an appointment based service and we aim to see you at your given appointment time, but if you have been referred as an emergency without an appointment time or if you require further assessment or investigations then there may be a waiting time to be seen, which can vary. However, at the time of your scan, you can be accompanied by your partner. The dimensions of the accessible toilet are 212cm x 220cm (6ft 11in x 7ft 3in). The height of the intercom is 134cm (4ft 5in). The wash basin cannot be reached from seated on the toilet. My CPD. But in others an ultrasound scan shows that the baby has died or not developed but has not yet been miscarried. 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. There is flooring in corridors which is shiny and could cause issues with glare or look slippery to some people. The specific roles of these authors are articulated in the author contributions section. To keep our patients safe, we are currently offering a telphone advice, triage and referral service. Walk-in Centres The height of the towel dispenser is 125cm (4ft 1in). If our guide needs updating - just let us know using this form. Your health professional will assess to see if you require a referral to the Early Pregnancy Unit. About the EPAU The Early Pregnancy Assessment Unit (EPAU) is a nurse-led service which provides specialist care for women who have, or who have had the following: Vaginal bleeding and/or pain in early pregnancy up to 16 weeks We are open Monday - Friday 08 - 20:00 (last patient accepted 19:15) and Saturday -Sunday 08:30 - 14:00 (last patient accepted 13:15). The main door(s) open(s) automatically (away from you). The contrast between the wall-mounted grab rails to the right of the toilet and wall is fair. Assistance may be required because there is/are slopes/ramps. The door(s) open(s) automatically (towards you). There are also several taxi services which run from the station. 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. This involves clinical review, investigations,diagnosis and treatment on the same day. There is not a flashing fire alarm beacon within the room. Gower Street - Southbound (University Street) - no's 10, 24, 29, 73, 134. 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%. The height of the soap dispenser is 97cm. The nearest standard toilets are located on the ground floor of the Elizabeth Garrett Anderson Wing. This is an external link. Your local Accident and Emergency department can still be used if you have an emergency or accident not related to your pregnancy (chest pain, difficulty breathing, collapse, etc). Please send a referral letter with all patients. Funding acquisition, Standard toilet facilities are available. On arrivalyou will be booked in by our dedicated admin clerk anddirected to the EPAU waiting area with your referral form and a number. General Practitioner (GP) There are not separate entry and exit doors in the lift. All units were asked to recruit a minimum number of 150 women each. EPAU opening times. The name / number of the room surveyed was; D190. Funding acquisition, This leaflet describes the different ways these kinds of miscarriages can be managed and what you might expect for each option. The door(s) is/are single width with a locked extension leaf. Where applicable, participants gave informed written consent before taking part in the study. The gynaecology emergency room (GER) at St Marys Hospital provides an acute seven-day service. If a family member or friend has accompaniedyou, the clinician will still request that a member of staff acts as chaperone for an intimate examination. We strive for continuous improvement and provide evidence based care. There is a low section of the desk (76cm or below) available. There is room for a wheelchair user to manoeuvre. There are several services which stop on Coxford Road outside the Princess Anne Hospital, they are the X11, U6C, the THREE and the 7 Bluestar and 17 Bluestar. There is not a door release button when exiting. There is a/are clearly marked/signposted Blue Badge parking bay(s) available. There is not a dropped kerb from the drop-off point. This may be a stressful time for both couples and their families and the unit aims to support you through the early stages of your pregnancy. 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 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. VESPA included the services provided by MASS in the submittal for funding to NIHR. The lighting levels are moderate to good. Radiotherapy patients receive a dispensation notice directly from the Radiotherapy department. You can find some more helpful advice regarding nausea and vomiting in pregnancy on the Pregnancy Sickness Support website, here. The Blue Badge bay(s) is/are signposted but have no markings. Please be aware that some external resources may be restricted to NHS Secure Network connections only. As you face the toilet pan the transfer space is on the left. There is sufficient space to write or sign documents on the low section of the desk. There is room for a wheelchair user to manoeuvre. EPAGU Level 2, Wellhouse Lane, Barnet, EN5 3DJ, 020 7472 6374, 020 7794 0500 ext 38205 or 31468, EPAGU 5th Floor, Pond Street, London, NW3 2QG, 020 7472 6374 (RFH) 020 8216 5233 (Barnet), Emergency clinic for women with pain or/and bleeding in early pregnancy or pregnant women with high risk of ectopic pregnancy, For recurrent miscarriages and early pregnancy concerns, For women with problems during early pregnancy. Unplanned admissions to hospital following any visit for investigations or treatment for first trimester complications as a proportion of women attending EPAUs. Peter Brocklehurst reports grants and personal fees from MRC, grants from MRC, NIHR HS&DR, NIHR HJTA, Wellcome Trust, personal fees from AG Biotest, outside the submitted work. The entrance area/door is clearly signed. Monday to Sunday 08:00 to 13:00. Patients already under the care of the early pregnancy assessment unit (EPAU) may contact the team through the following number: 01904 726489 . 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. There is step free access, via lift, to Clinic 3 - Early Pregnancy Unit. Opening Hours for patient assessment and care planning. There is level access throughout the department/service. 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. Child Emotional Wellbeing & Mental Health, Learning Disabilities & Neurodevelopmental Disorders (NDD), Gastroenterology, Colorectal, Renal & Urology, Care Home Training & Development (Islington), Data quality/standard referral form programme, 020 7472 6374(RFH) and 020 8216 5233 (Barnet), 020 7472 6374 (rfh: specialist nurse advice during opening hours) or020 7794 0500 ext 38205 or 31468, Early Pregnancy Assessment & Gynaecology Unit: RFL, assessment and management of women with pain and bleeding in early pregnancy (up to 15 weeks and sixdays), assessment of women at high risk of an ectopic pregnancy, assessment and management of women with acute gynaecological problems. Tommys Tommy's is a charity that funds research for pregnancy and babies. We recommend upgrading your browser to continue. Visualization, 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). It has been created to raise awareness and help others to see that what they are going through is completely normal. View on a map. The Early Pregnancy Unit runs in parallel with the Gynaecology Assessment Unit (GAU) and provides services for women with complications of pregnancy . The car park does not have a height restriction barrier. Mirrors are placed at a lower level or at an angle for ease of use. The hospital does have a dedicated car park. If you have symptoms of pain and or bleeding in the first 13 weeks of pregnancy you may want to seek advice. Patients can call 0203 447 3013 to request a dispensation notice in advance. Please do not contact the Early Pregnancy Unit to arrange an appointment with the midwife. 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. Treatments available for ectopic pregnancies includelaparoscopic surgery, medical treatment with methotrexate, or expectant management. This accessible toilet is located along the department corridor. The distance between the floor and the highest table is 43cm (1ft 5in). Urgent GP referrals are seen on the same day. These three factors were selected as being important factors associated with clinical outcomes from the literature [6]. Writing review & editing, Roles Site by daysix. No, Is the Subject Area "Miscarriage" applicable to this article? The height of the soap dispenser is 99cm. Prior to unit recruitment, a national survey was distributed to all 212 EPAUs operating in UK NHS hospitals between 2015 and 2016. The lift is located to the right as you enter the Elizabeth Garrett Anderson Wing main entrance. We would like to thank Ms Heidi Chandler; whose hard work and dedication was instrumental in securing the funding for this study. The clinic reception is located to the left as you enter. A mobility scooter charging point is not available at the hospital. There are 4 consultation/treatment rooms in this department/service. The median admission rate among 44 units was 2.8% (range 0% to 13.7%) (Fig 1). Whilst the majority of pregnancies will progress without complications, many women experience problems that they feel they would like support or further information for. a new pregnancy and under the care of the recurrent miscarriage clinic. Opening times Weekdays: 07:30 - 15:00 Weekends and Bank Holidays: 09:00 - 13:00 Contact us Patients already under the care of the EPAU may contact the unit on 01274 364325 and Ward 20 on 01274 364414. The hospital does have a dedicated car park. 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. The towel dispenser can be reached from seated on the toilet. The primary outcome for the VESPA study was the number of emergency admissions as a proportion of women attending each participating EPAU. No, Is the Subject Area "Cohort studies" applicable to this article? No, Is the Subject Area "Critical care and emergency medicine" applicable to this article? EPAU is a specialist unit that manages early pregnancy problems such as vaginal bleeding and abdominal pain. Conceptualization, There is/are 7 designated Blue Badge parking bay(s) within the hospital car park. Opening hours This line is open Monday to Friday 10-12pm Women's choices Use this number to discuss your pregnancy options 01592 6433355 ext 25445 Email: fifewomenschoices@nhs.scot Opening hours This line is open Monday to Friday 11am-3pm Bleeding in the early stages of your pregnancy? The tube stations are located at opposite ends of the hospital main building. The wash basin is not placed higher than 74cm (2ft 5in). Please call the ward to find out more. There is / are 10 consultation / treatment room(s) available. MASS Ltd is a business consultancy specialising in analytics, data modelling, and workforce planning and configuration. The aim was to capture hospital emergency activity with regards to early pregnancy care in EDs. 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. The height of the reception desk is high (110cm+). In addition to senior clinicians presence, we also explored the effect that weekend opening of an EPAU has on emergency admissions.
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