• Salim Maher, Sarah Rolls, Gokulan Pavendranathan, Sean Westbury, Anna C Akon, and Amany Zekry.
• Department of Gastroenterology and Hepatology, St George Hospital, Sydney, New South Wales, Australia.
• Intern Med J. 2022 Sep 1; 52 (9): 1525-1530.

BackgroundColorectal cancer is the second most common cause of cancer-related mortality in Australia. As such, timely access to colonoscopy following a positive faecal occult blood test (FOBT) is an important aspect of the National Bowel Cancer Screening Program to reduce morbidity and mortality related to this condition. To reduce waiting times, a Sydney-based referral centre introduced a nurse-led virtual clinic (VC) in order to facilitate direct access colonoscopy for patients referred with a positive FOBT.AimsTo evaluate the efficacy of a nurse-led VC model to reduce waiting time to colonoscopy and to determine the patient experience of the model.MethodsThe VC model, piloted for a 14-month period, was compared with the standard outpatient clinic (SOC) model over the 14-month period preceding the VC. Primary outcomes included time to colonoscopy and secondary outcomes included adverse events, bowel preparation and cancellation rates. Patient experience was evaluated through an emailed survey.ResultsCompared to the SOC model, the VC model reduced waiting time to colonoscopy from date of positive FOBT by 71 days (P = 0.0006) and from date of referral by 66 days (P < 0.0001). There was no significant difference in secondary outcomes. All respondents to the survey (n = 30) reported a positive experience.ConclusionsNursing-led VC, with direct access colonoscopy for patients at increased risk of colorectal cancer, reduce waiting times to colonoscopy without an increase in adverse events and is well received by patients.© 2021 Royal Australasian College of Physicians.

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