Advertisement

 

 

Surgical assessment clinic – One stop emergency out-patient clinic for rapid assessment, reduced admissions and improved acute surgical service: A quality improvement study.

Surgical assessment clinic – One stop emergency out-patient clinic for rapid assessment, reduced admissions and improved acute surgical service: A quality improvement study.
Author Information (click to view)

Macano CAW, Kirby GC, Lake B, Nyasavajjala SM, Clarke R,


Macano CAW, Kirby GC, Lake B, Nyasavajjala SM, Clarke R, (click to view)

Macano CAW, Kirby GC, Lake B, Nyasavajjala SM, Clarke R,

Advertisement

Annals of medicine and surgery (2012) 2017 09 2823() 28-31 doi 10.1016/j.amsu.2017.09.016
Abstract
Background
There is increasing pressure on emergency services within the NHS requiring efficient, rapid assessment and management of patients. A subsequent reduction in hospital admissions reduces overall costs with an aim to improve quality of care. At the Royal Shrewsbury Hospital we run a one stop emergency surgical clinic. With strict criteria for admission to this clinic we have established a care pathway for those patients requiring urgent surgical review but not necessarily hospital admission.

Materials and methods
We reviewed our initial referral pathway to the emergency surgical assessment clinic. New guidelines were distributed to the local Care Coordination Centre (CCC) through which GP referrals to the clinic were made. A re-audit carried out 6 weeks later assessed change in clinical practice.

Results
With the introduction of guidelines for referral we significantly increased the percentage of appropriate referrals to the one stop emergency surgical clinic (42.9%-79.4%, p = 0.000017). The majority (75.8%) of appropriate referrals can be successfully managed on an urgent outpatient basis. Appropriate referrals unsuitable for discharge from clinic had genuine reasons for admission such as abnormal results on assessment, or a need for surgery. 97.8% of referrals not deemed appropriate for the clinic were admitted for inpatient management.

Conclusion
By providing suitable guidance for referring practitioners we have optimised our clinic use significantly and improved our acute ambulatory surgical care. We have reduced admissions, provided rapid treatment and have established a service that helps address the ever increasing demand on acute services within the NHS.

Submit a Comment

Your email address will not be published. Required fields are marked *

14 − eleven =

[ HIDE/SHOW ]