Aim: To evaluate utilisation, yield and clinical impact of endocrine dynamic testing performed within John Hunter Hospital [JHH] Endocrine service since specialised registered nurse implementation.
Methods: A retrospective audit was undertaken of patients who underwent endocrine dynamic testing between June 2024 and June 2026 at JHH, servicing the Hunter New England region of NSW across 130,000km²₁. A specialist Endocrine nurse was introduced in 2024 to coordinate medication withholding protocols, test scheduling, pre-test assessment and clinical monitoring to provide safe, efficient care. Data collected included wait time between referral and test completion, indication, testing type, success rates and ongoing clinical management. Dynamic tests performed included Seated Saline Suppression Test [SSST], Glucagon Stimulation Test [GST], Mixed Meal Test [MMT], Short Synacthen Test, OGTT for Growth Hormone suppression, Clonidine Suppression Test, Water Deprivation Test [WDT] and Dexamethasone-CRH Test.
Results: 137 endocrine dynamic tests were performed. SSST was the most common (58.4%), followed by MMT (26.3%). Mean waiting times varied by test type. GST wait time improved significantly from 204 days (2024) to 33 days (2026). MMT wait times remained stable (97-112 days). In contrast, SSST wait times increased from approximately 120 days (2024-2025) to 159 days (2026), suggesting increasing demand for primary aldosteronism assessment and capacity challenges. One adverse event occurred during a SSST, with a patient developing acute pulmonary oedema requiring urgent treatment and admission.
Discussion/Conclusion: Endocrine dynamic testing provides clinically important results directly influencing patient management. A dedicated endocrine nurse improved coordination, patient preparation, and monitoring to support operational efficiency. The adverse event highlighted importance of specialist nursing assessment, monitoring and early recognition of complications during testing. These findings demonstrate need for dedicated testing facilities, specialist nursing backfill, and service planning that accounts for competing demands on hospital capacity and major health system transformations.