Speakers - 2026

Title: Back to the Bedside: Teaching Paracentesis as a Tool to Improve Oncology Patient Outcomes, Hospital Efficiency and Team Morale

Abstract

The teaching of medical skills in the UK is increasingly compromised by rising clinical workloads with an expanding population of ever more complex, multi-morbid patients. Competition for training places is growing whilst the actual training itself is progressively difficult to get “on the job”. As a consequence, patients are suffering. In a Tertiary Oncology Centre, paracentesis was previously performed solely by the Radiology department, resulting in Oncology patients, commonly Gynaecology Oncology patients, often waiting weeks for symptomatic relief from their symptoms. Patients who already had short prognoses were spending this time in pain, short of breath, often bed bound, nauseous and unable to eat or drink and then kept nil-by-mouth sometimes for days as they awaited procedures which could be re-arranged at the last minute. In this single Oncology department, through identification of Doctors who were able to perform paracentesis, in one medical rotation a high proportion of the medical team were trained to perform paracentesis through a cascade effect of this single skill being taught. The benefits were multifaceted. As a result, the time taken to perform paracentesis was reduced from an average of 3.8 days, to 1.2 days, with no extra complications. This not only reduced patient suffering and shortened hospital stay, but also freed up radiology slots for other complex procedures and provided increased professional satisfaction to the medical team who had learnt a new skill. These doctors who are now trained in paracentesis are going to rotate away from the team to other departments and other hospitals where they can disseminate this skill further. This is one simple procedure that exemplifies the traditional “see one, do one, teach one” approach to clinical skills. This experience demonstrates that with encouragement from seniors, proactive identification of clinicians with the appropriate skills, and confidence to identify appropriate patients and teach, this could have a drastic impact on patient outcomes, inpatient flow and staff satisfaction. In a period of low morale within the medical workforce and more emphasis on service provision, reclaiming bedside procedural skills may represent a simple yet powerful intervention to improve patient care.

What will the audience take away from presentation?

• Be able to have confidence in identifying patients who have the potential to benefit from paracentesis
• Be aware of the benefits that paracentesis can provide for the patients
• Be aware of the risks and contraindications to paracentesis
• Have the confidence to identify doctors with skills such as paracentesis that can be passed on to other members of the team

How will this help the audience in their job? Is this research that other faculty could use to expand their research or teaching? Does this provide a practical solution to a problem that could simplify or make a designer’s job more efficient? Will it improve the accuracy of a design, or provide new information to assist in a design problem? List all other benefits.

• This is research that could benefit any inpatient team which cares for Gynaecology-Oncology patients
• Whilst there is a higher burden of initial input required from teams in terms of identification of doctors with the skill and cascading of the skill to other team members, the benefits far outweigh this and the input required will decrease as time goes on and skills are passed on
• Implementation of pathways such as this would streamline patient pathways