• Laura Whitelaw, Kellie Hammond, Melissa Cumming, Kylie Mansfield, and Emily Saurman.
• Princess Alexandra Hospital, Metro South Health, Woolloongabba, Queensland, Australia.
• Aust J Rural Health. 2020 Feb 1; 28 (1): 81-86.

ObjectiveThis pilot project aimed to assess whether the Direct Access Colonoscopy Clinic is an effective and safe model to reduce the time from a positive faecal occult blood test referral to a gastroenterologist-performed colonoscopy, and its effect on meeting the 120-day recommendation.DesignBefore/after clinical practice and patient file audit.SettingBroken Hill Health Service.ParticipantsDe-identified data from all positive faecal occult blood test colonoscopies performed in the Broken Hill Health Service in October 2016-January 2017 (Pre-Direct Access Colonoscopy Clinic) and October 2017-January 2018 (Post-Direct Access Colonoscopy Clinic).Main Outcome MeasuresVariables included referral date, indication, initial appointment date, colonoscopy date, colonoscopy finding, bowel preparation and adverse events. Colonoscopies indicated by positive faecal occult blood test results were the focus.ResultsThe nurse-consulted Direct Access Colonoscopy Clinic cohort (n = 22) had a significant 139-day reduction from positive faecal occult blood test referral to colonoscopy compared to the Pre-Direct Access Colonoscopy Clinic cohort. All Direct Access Colonoscopy Clinic patients met the new 120-day recommendation for wait-time from referral to colonoscopy. Following the introduction of the Direct Access Colonoscopy Clinic, no immediate adverse events were documented for patients using either the conventional or Direct Access Colonoscopy Clinic pathways.ConclusionsThe Direct Access Colonoscopy Clinic offers a safe and effective intervention that reduces wait-time to colonoscopy in eligible patients with positive faecal occult blood test within the recommended 120 days. Further research is recommended, but Direct Access Colonoscopy Clinic has the potential to improve timely access to colonoscopy services and outcomes for all positive faecal occult blood test patients.© 2019 National Rural Health Alliance Ltd.

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