Emergency general surgery 'Hot Clinics' reduce admission rates and duration of inpatient stay.
Frontline Gastroenterol
; 8(1): 53-61, 2017 Jan.
Article
em En
| MEDLINE
| ID: mdl-28839885
ABSTRACT
OBJECTIVE:
To determine the impact of a 'Hot Clinic' (HC) on emergency general surgery patient flow-through.DESIGN:
Prospective service evaluation study.SETTING:
HC is a four-bedded area coordinated by a specialist nurse. The HC consultant sees emergency patients referred from the emergency department, general practitioners or those in preceding 24â h considered suitable for interim discharge while awaiting investigations and HC reassessment. PATIENTS All patients with acute abdominal pain were evaluated in three 4â week groups before (group 1), 1â month (group 2) and 6â months after the HC was introduced (group 3). Interhospital transfers, intrahospital ward referrals and trauma patients were excluded. INTERVENTION Introduction of consultant-led surgical HC every weekday afternoon. MAIN OUTCOMEMEASURES:
Proportion of patients admitted under general surgeons, length of inpatient stay and the proportion of patients referred again within 3â months were investigated.RESULTS:
1409 patients were referred, of which 1061 met the inclusion criteria 307 in group 1, 326 in group 2 and 428 in group 3. There was no difference in gender distribution (p=0.759). Inpatient admissions were significantly reduced (85.0% vs 78.2% vs 54.4%; p<0.001) and the inpatient duration of stay was significantly shorter after HC introduction (median (IQR) (95% CI) 63.8 (29.0-111.6) (51.8 to 72.8) hours vs 48.8 (21.7-101.2) (42.0 to 55.6) hours vs 47.7 (20.9-92.7) (42.8 to 56.9) hours; p=0.011).CONCLUSIONS:
Emergency general surgery HCs are associated with significant reductions in admission rates and inpatient bed occupancy. This service redesign has the potential to dramatically relieve pressure on acute surgical services.
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Base de dados:
MEDLINE
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article