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A customised ENT admissions proforma and novel online ‘clerking collaborative’
  1. Ahmad A Hariri,
  2. Rachel Edmiston,
  3. Navin Mani,
  4. Simon K Lloyd
  1. Manchester Royal Infirmary, Manchester, UK
  1. Correspondence to Ahmad A Hariri, Department of ENT, Manchester Royal Infirmary, Oxford Rd, Manchester M13 9WL, UK; mr.ahariri{at}


Objectives Admissions clerking proformas are commonly used in hospitals to aid complete patient assessment. Much variation remains in the format of these forms and they frequently fail to account for local-specific and specialty-specific factors. We developed and piloted the use of a novel ear, nose and throat (ENT) clinic admissions clerking proforma and created a national online ‘clerking collaborative’.

Methods Doctors completed ‘mock clerkings’ for 6 common acute ENT presentations by both traditional methods (freehand) and using our customised ENT diagrams. Participants were timed throughout the process and asked to complete a feedback survey. A senior ENT clinician provided structured feedback comparing the quality of each type of clerking.

Results 9 junior doctors participated in the exercise. 5 participants started with freehand drawings while the remainder used our clerking proforma first. Our customised diagrams provided accurate representations of the clinical scenarios, and were easier and faster to complete than free drawings. They were also easier to interpret and best represented the clinical findings compared with freehand clerkings. A website ( was created to disseminate the clerking proforma and to allow other clinicians to contribute improvements.

Conclusions Accurate and legible clerkings are essential to allow for continuity of care and management. This is particularly important in ENT, where drawings are frequently used to describe clinical findings. Our predrawn diagrams speed up the clerking process and allow for more accurate depiction of findings. We have designed an online ‘clerking collaborative’ where doctors can download our proforma, contribute improvements and upload their own ideas for other specialties.

  • Accessible
  • Assistive Technology
  • Otolaryngology

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