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This was an innovation project supported by the Better Care Victoria Innovation Fund.

Lead organisation

Peninsula Health

Summary

Each year, Peninsula Health performs approximately 520 procedures on women who are admitted for surgery to investigate abnormal uterine bleeding (hysteroscopy) or to manage early pregnancy loss. 

These procedures involve a general anaesthetic and usually require a hospital stay of between 12 and 24 hours. However, the use of general anaesthetic carries the risk of potential complications, such as postoperative nausea and vomiting or a severe allergic reaction (anaphylaxis), and can lead to an extended recovery time.

Peninsula Health developed two ambulatory services to provide women experiencing early pregnancy loss or abnormal uterine bleeding with safe, effective alternatives to having surgery under general anaesthesia.

Aims

  • Provide alternative access and treatment options for women with dysfunctional uterine bleeding and early pregnancy loss by implementing an ambulatory care clinic in Peninsula Health
  • Improve patient and staff experiences
  • Reduce wait times for accessing hysteroscopy and treatment of early pregnancy loss 
  • Reduce total length of stay (LOS) after hysteroscopy and surgical treatment of early pregnancy loss
  • Reduce the risk and adverse outcomes related to the use of general anaesthesia on women having short, low-impact surgical procedures

Outcomes

  • Reduced total LOS and average recovery time by 68 per cent and 80 per cent, respectively, for patients who opted for the ambulatory hysteroscopy service
  • Eliminated the risks associated with general anaesthesia for patients undergoing an ambulatory hysteroscopy or early pregnancy loss treatment by using local anaesthetic and sedation
  • All ambulatory service patients were seen within 21 days of referral, leading to more efficient surgical wait list management and the release of resources for other patients
  • Achieved estimated treatment cost savings of more than $1,700 per patient for both ambulatory services

Update

December 2020 – The ambulatory hysteroscopy service is now a well-established and integrated service at Peninsula Health, performing four hysteroscopies each clinic, with high levels of satisfaction and low pain scores an ongoing feature. 

The shutdown of elective surgical cases during the coronavirus (COVID-19) pandemic put pressure on the need for urgent hysteroscopies for the early screening of suspected endometrial cancer. With some modification of the service, Peninsula Health was able to provide a COVIDSafe alternative to admission to hospital.

Page last updated: 18 Dec 2020

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