The clinic reception is located to the left as you enter. 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. There are standard toilet facilities within this department/service. We have placed cookies on your deviceto help improve our website. The soap dispenser can be reached from seated on the toilet. 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 ramp/slope is located in front of the entrance. Patients who are experiencing a loss are given contact numbers and information on how to obtain support from the Miscarriage Association. For more information about what these symbols mean, view our Accessibility Symbols Guide. The telephone number for the Patient Advice and Liaison Service (PALS) is 020 3447 3042. We see women in the first 18 weeks of pregnancy only. Involvement of senior clinicians in delivering early pregnancy care has no significant impact on emergency hospital admissions for early pregnancy complications. We chose to study the rate of emergency admissions which is a recognised quality outcome indicator for acute hospital units [19, 20]. Equally, weekend opening of an EPAU, even for a limited number of hours, is associated with lower probability of emergency hospital admissions. There is not a door release button when exiting. Data curation, The dimensions of the accessible toilet are 212cm x 220cm (6ft 11in x 7ft 3in). The alarm was out of reach (higher than 10cm (4") from floor) when surveyed. e0260534. 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. However, at the time of your scan, you can be accompanied by your partner. This was due to the changes in provision of medical cover which occurred between the site initiation visit and the start of recruitment. Where applicable, participants gave informed written consent before taking part in the study. 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. this will normally be done within 2 days and you will need to be nil by mouth for 6 hours. Nausea and vomiting in early pregnancy affects up to 80% of pregnant women. The contrast between the dropdown rail(s) and wall is fair. The unit is open Monday to Fridayfrom 7.30am to 8pm with scanning facilities from 9am-5pm. Barnet Hospital also offers a walk-in service. Contact details for early pregnancy services for your Trust can be found on the homepage. If you are experiencing heavy bleeding and/or severe pain, or feeling dizzy, please go straight to the Emergency Department. Your local early pregnancy unit is still available but opening times and appointment availability may have changed. 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. When you attend an event booked through the North Central London GP Website, Software, Copyright 2023 East and North Hertfordshire NHS Trust. The emergency pull cord alarm is not fully functional. Traffic light controlled pedestrian crossing points are located adjacent to each tube station. 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. 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. 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. 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. There is step free access into the imaging room. This information is for the entrance located on Grafton Way. The door does not have a horizontal grab rail. We see women in the first 17 weeks of pregnancy only (up to 14 weeks at Basildon University Hospital). 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. There is room for a wheelchair user to manoeuvre. The route from the car park to the entrance is accessible to a wheelchair user with assistance. The width of the accessible toilet opening is 84cm. This is based on 6397 women that had complete information on the outcome and key characteristics. . There is sufficient space next to the bed/couch for a mobile hoist to operate. The lift is located to the right as you enter the Elizabeth Garrett Anderson Wing main entrance. 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%. However, our study is the first large prospective study designed with a specific aim to study emergency admission rates in women presenting with acute first trimester pregnancy complications. 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. Princess Anne Hospital, Coxford Road, Southampton, Hampshire, SO16 5YA. The accessible toilet does not have an unobstructed minimum turning space of 150cm x 150cm in front of the seat. 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. 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. 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. 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? For service contact details please visit the relevant service page. Guidelines: care is provided to women following guidelines that have been produced by the department. Theyprovide a range of services such as peer support and counselling services. EPAU opening times EPU is open to talk to or be seen by a nurse from 7.30am to 8pm. b) vaginal bleeding The toilet roll holder is not placed higher than 100cm (3ft 3in). Report a problem or suggestion using this facility. Project administration, The car park is located to the left of the main underground car parks. Supervision, Gynaecology Outpatient Department,Ground floor, Green Zone, Lewisham High Road, SE13, Gynaecology Outpatients Department, Stadium Road, Greenwich, London SE18 4QH. We are able to offer electives for medical students. The miscarriage association have put together acollection of storiesabout experiences of pregnancy after loss. The towel dispenser can be reached from seated on the toilet. Google map of Princess Anne Hospital Location. The gynaecology emergency room (GER) at St Marys Hospital provides an acute seven-day service. Early Pregnancy Unit and Gynae Assessment Unit is approximately 14m from the Level D entrance. Roles PLOS ONE promises fair, rigorous peer review, This accessible toilet is located along the department corridor. Project administration, There is not a play area or toys/books for a child to play with. The contrast between the toilet roll holder and the wall is good. There is / are 4 consultation / treatment room(s) available. www.aepu.org.uk The Association of Early Pregnancy Units providessupport and resources to help patient choice and maintain standards in Early Pregnancy Care. The unit characteristics were confirmed again immediately prior to commencing patient recruitment. The IHE receives funding from, and collaborates with, government, academic, not-for-profit and private sector organisations. Clinic 3 - Early Pregnancy Unit is approximately 35m from the lift. They are organisational structures which operate in most acute hospitals in the UK and an increasing number of other countries worldwide [14]. The width of the accessible toilet door is 87cm (2ft 10in). A previousmolar pregnancy, not less than 8 weeks gestation. The specific roles of these authors are articulated in the author contributions section. 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. In addition to senior clinicians presence, we also explored the effect that weekend opening of an EPAU has on emergency admissions. We apologise for any inaccuracies in the following list of contributors, whose primary role has been described. 205/6397 (3.2%; 95% CI 2.83.7) women were admitted following their EPAU attendance. The transfer space is obstructed by a waste disposal bin. 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. 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. Final diagnosis (FD) was divided into five groups: 1) Normal intrauterine pregnancy including early and live pregnancies; 2) Abnormal intrauterine pregnancy including early embryonic demise, incomplete, and complete miscarriage; 3) Ectopic pregnancy at any site; 4) Pregnancy of unknown location; and 5) Other: molar pregnancy, multiple pregnancy, and not pregnant. Supervision, The height of the soap dispenser is 100cm. Location and opening times The EPU is based in the gynaecology clinic on the ground floor of Lanesborough Wing. 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 have a dedicated team of nurse practitioners, doctors, sonographers and consultants who aim to offer seamless care to assess, diagnose and offer treatment and support if required. 08.30am - 7.00pm Monday - Friday; 9.00am - 4.00pm Saturday, Sunday and Bank Holiday (except Christmas Day) Ultrasound services 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 hoist can be brought in from another department. There are accessible toilet facilities within the department/service. 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. This analysis was based on the 29 units (5,464 patients) that were able to provide us with reliable data regarding the attendances to Emergency Department and emergency admissions out of hours. Click through the PLOS taxonomy to find articles in your field. Validation, These are further broken down by diagnosis in Tables 3 and 4. https://doi.org/10.1371/journal.pone.0260534.g001, https://doi.org/10.1371/journal.pone.0260534.t002, https://doi.org/10.1371/journal.pone.0260534.t003, https://doi.org/10.1371/journal.pone.0260534.t004. Data curation, To keep our patients safe, we are currently offering a telphone advice, triage and referral service. There are sofas and also a mixture of single seats with and without armrests. The door(s) open(s) away from you (push). The car park is located at the side of the Elizabeth Garrett Anderson Wing. When describing your problem or suggestion, The reception area/desk is clearly visible from the entrance. However, there was evidence of an association between the emergency admission rate and weekend opening hours. 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. The route from the car park to the entrance is accessible to a wheelchair user with assistance. There is space for an assistance dog to rest within the seating area. The wash basin is not placed higher than 74cm (2ft 5in). The Early Pregnancy Unit assesses women with complications such as pain, bleeding and excessive vomiting. It is also unclear whether completion of the module is a requirement locally for appointment to EPAU leadership roles. It has been created to raise awareness and help others to see that what they are going through is completely normal. Both units accept referrals from GPs, the urgent care centre, the antenatal clinic and A&E. The unit is open Monday to Friday, from 9am-5pm. The lighting levels at the reception point are good. Contact. We care for women with acute early pregnancy problems and acute gynaecology issues. Pinderfields Hospital Please be aware that some external resources may be restricted to NHS Secure Network connections only. Yell.com Yell Business. Forty units met this target, whilst four units recruited between 143 and 149 women. Gower Street - Southbound (University Street) - no's 10, 24, 29, 73, 134. Mobility aids are available to help patients move around and include; wheelchairs and crutches. In some miscarriages the uterus (womb) empties itself completely. GAU is a 24 hour service and can offer advice and . We are now welcoming self referrals from women,however, we will still accept referrals from the existing pathway. The barrier controls/touchscreen can be reached from the car. Access to Clinic 3 - Early Pregnancy Unit is via the Elizabeth Garrett Anderson Wing main entrance. The car park surface is a shared surface. The car park does not have a height restriction barrier. But in others an ultrasound scan shows that the baby has died or not developed but has not yet been miscarried. Site by daysix. In addition, we recorded the amount of time senior clinicians (consultant gynaecologists) spent working in EPAUs which is of critical importance when assessing the impact of their presence on various clinical outcomes. Do you want to change or cancel an appointment? t: 020 7794 0500 ext 38205 or 31468. Scans appointments are every weekday morning and afternoon. Conceptualization, The Patient Advice and Liaison Service (PALS) is located on the ground floor of the main University College Hospital building. Models were either unadjusted or adjusted for gestational age unit policy. The VESPA study recruited from the EPAU population. Try to follow the advice about drinking little and often to avoid this as much as you can. The entrance area/door is clearly signed with the name of the service/department. Formal analysis, Investigation, 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. They are not issued to carers, relatives, visitors or friends who are Blue Badge holders bringing a non-Blue Badge holder patient to an appointment. A moderate level of clustering within units (Intraclass Correlation Coefficient, ICC = 0.04) was assumed. View Article PubMed/NCBI . They were also similar if we consider patients with normally-developing pregnancies (FD group 1) and abnormally-developing pregnancies (FD groups 25) (Table 6). The drop-off point is located to the right of the Level D entrance. An email request option is offered where the completed dispensation will be emailed so the patient/carer can print prior to arriving for their appointment, email requests are via. There is a/are door(s) into the consultation / treatment room. Unplanned admissions to hospital following any visit for investigations or treatment for first trimester complications as a proportion of women attending EPAUs. The primary outcome for the VESPA study was the number of emergency admissions as a proportion of women attending each participating EPAU. As our hospitals are teaching hospitals, medical or midwifery students may be present during your appointment. The Early Pregnancy Unit is a consultant-led service and is delivered by a team of specialist nurse sonographers who provide consultation, assessment, scans and treatment plans for women with complications of pregnancy from 5 to 20 weeks. The wash basin is placed higher than 74cm (2ft 5in). Conceptualization, You can at any time read our cookie policy. There is dedicated team of trained sonographers and consultants who provide the ultrasound services. If you are not under the care of the EPAU, please contact your GP. This video animation tells the story of one couples experience of miscarriage. The towel dispenser cannot be reached from seated on the toilet. The contrast between the internal door and wall is good. The contrast between the internal door and wall is good. If you do not require an ultrasound but other investigations are indicated, the team will facilitate you into a suitable appointment. EPAU is located on Level 2, Area 7, Burnley General Teaching Hospital. Copyright 2023 Imperial College Healthcare NHS Trust, Early pregnancy and acute gynaecology units, Assessment of women with bleeding and/or pain in early pregnancy, Diagnosis and subsequent management of miscarriage and ectopic pregnancy, Nausea and vomiting in pregnancy (hyperemesis), Gynaecology: scans for suspected pelvic pathology requiring emergency review, Possible ovarian cyst accidents (ovarian cyst rupture or torsion), Significant heavy menstrual bleeding with anaemia requiring hospital admission, Expectant, medical and surgical management of miscarriage, Management of ectopic pregnancy: medical, surgical and close monitoring with expectant management, Inpatient and outpatient management of nausea and vomiting in pregnancy, Surgical management of molar pregnancy and liaison with the, Incision and drainage of Bartholins cysts and abscesses under local anaesthesia or general anaesthesia. 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. Senior clinicians were present only in 19 of the 44 EPAUs. No, Is the Subject Area "Hospitals" applicable to this article? 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. Walk-in centres can be accessed by anyone and have more flexible opening hours. If you are based within a GP practice please contact the GPIT Helpdesk on WF1 4DG. 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. Elizabeth Garrett Anderson Institute for Womens Health, University College London, London, United Kingdom, Roles There is not a/are not Blue Badge parking bay(s) available. 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. There is a dark mat or floor marking at this entrance that might be perceived as a hole. Monday to Sunday 08:00 to 13:00. https://doi.org/10.1371/journal.pone.0260534.t005, https://doi.org/10.1371/journal.pone.0260534.t006. View on a map. The aim was to capture hospital emergency activity with regards to early pregnancy care in EDs. Detailed information, also The height of the toilet seat above floor level is 48cm (1ft 7in). These three factors were selected as being important factors associated with clinical outcomes from the literature [6]. broad scope, and wide readership a perfect fit for your research every time. Writing review & editing, Affiliations Birmingham Clinical Trials Unit, Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom, Roles Despite the fact that an advanced training module in acute gynaecology and early pregnancy has been running for a number of years from The Royal College of Obstetricians and Gynaecologists, to our knowledge, a rigorous assessment of its quality and effectiveness has not been undertaken [21]. The lift is approximately 24m (26yd 9in) from the Elizabeth Garrett Anderson Wing main entrance. 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 dedicated staff are sensitive and committed to supporting the emotional needs of women and couples requiring this service. The door(s) open(s) away from you (push). This accessible toilet is located to the right as you pass through the waiting area. The height of the toilet roll holder is 118cm (3ft 10in). If our guide needs updating - just let us know using this form. Writing original draft, 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 waiting room / area does not have background music playing. 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. Get contact details, videos, photos, opening times and map directions. As you face the toilet the wall-mounted grab rails are on both sides. 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. There are parking charges for the hospital car park. The width of the door opening is 86cm (2ft 10in). The soap dispenser cannot be reached from seated on the toilet. Staff do not need to be notified for use of the lift. Accessible toilet facilities are available. You can visit a walk in centre for any general illness or concern for which you may have visited your GP. There is a/are door(s) leading into the department/service. The EPAU is a specialist unit that manages early pregnancy problems such as vaginal bleeding and abdominal pain. You can catch the Bluestar 17 and City Red Three buses from the station - both continue to Southampton General Hospital and Princess Anne Hospital. The service provides specialist care for the following: Where medically appropriate, we offer a range of management options for conditions in early pregnancy and acute gynaecology. 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. The dimensions of the designated Blue Badge parking bay(s) surveyed are 410cm x 440cm. The wash basin and tap(s) can be reached from seated on the toilet. If you require an ultrasound we aim to offer this within 72 hours of referral. It is not intended for public use. There is a dropped kerb from the drop-off point. There is a payment machine at a convenient height for wheelchair users. The staff in the unit are skilled in the management of early pregnancy complications,including ultrasound scanning. The route from the car park to the hospital entrance is not clearly signposted. Continue along Grafton Way and rejoin the A400. The contrast between the walls and floor is good. A user-led organization (Miscarriage Association), through its national director, acted as a co-applicant and collaborator. The Ectopic Pregnancy Trust There was no apparent relationship between planned senior clinician presence and emergency admissions (Fig 2). 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%. We ask that they call the unit so that we can book them a timed appointment. The toilet is not for the sole use of disabled people. The VESPA study received a favourable ethical opinion from the North West Research Ethics Committee (REC reference 16/NW/0587) in the UK, registration number ISRCTN 10728897. It is likely that the caller ID will show as a private number orwithheld number. The width of the door opening is 88cm (2ft 11in). here. Your local early pregnancy unit is still available but opening times and appointment availability may have changed. Funding acquisition, Investigation, Clinic 24 is a small, but busy, unit based on Level 1 in the Rosie. Investigation, Visualization, Elizabeth Garrett Anderson Wing, University College Hospital, 25 Grafton Way, London, WC1E 6DB. EPAU is a specialist unit that manages early pregnancy problems such as vaginal bleeding and abdominal pain. There are not volunteers available for help and assistance at the hospital. We next investigated the relationship between emergency admissions from the Emergency Department and planned senior clinician presence in EPAU, unit volume and weekend opening hours of the EPAU. The nearest designated Blue Badge parking bay is approximately 15m (16yd 1ft) from the Level C lift lobby. 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 over Cardiff and the Vale of Glamorgan. The height of the reception counter is low (76cm or lower) . There is level access into the waiting room / area. a new pregnancy and under the care of the recurrent miscarriage clinic. Department of Statistical Science, University College London, London, United Kingdom, Roles Opening hours: Mon-Fri 7.30am-8pmwith scanning facilities from 9am-5pm. There is level access into the day room/lounge area. Discover a faster, simpler path to publishing in a high-quality journal. Clinic 3 - Early Pregnancy Unit is/are located on the lower ground floor. Writing review & editing, Roles The toilet roll holder can be reached from seated on the toilet. Please check the latest information before planning your journey. There is not an assistance dog toilet or toileting area on the hospital site. Two sets were used because IMD and gestational age policy had a reasonable amount of missing data. BSL interpreters can be provided on request. There is a space for a wheelchair user to manoeuvre. We recommend upgrading your browser to continue. 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 intercom is in a suitable position to allow wheelchair users to gain access. There is not sufficient space to write or sign documents on the counter. The car park does have a barrier control system. Index of Multiple Deprivation (IMD) was calculated based on the home address postcode of the patient at the time of patient recruitment. Conceptualization, 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.