Dataset Information

Emergency general surgery 'Hot Clinics' reduce admission rates and duration of inpatient stay.

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 24?h considered suitable for interim discharge while awaiting investigations and HC reassessment.

Patients

All patients with acute abdominal pain were evaluated in three 4?week groups: before (group 1), 1?month (group 2) and 6?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 outcome measures

Proportion of patients admitted under general surgeons, length of inpatient stay and the proportion of patients referred again within 3?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.

SUBMITTER: Th'ng F

PROVIDER: S-EPMC5369429 | biostudies-literature | 2017 Jan

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Emergency general surgery 'Hot Clinics' reduce admission rates and duration of inpatient stay.

Th'ng Francesca F Skouras Christos C Paterson-Brown Alice A Ravindran Rajan R Lamb Peter P de Beaux Andrew A Paterson-Brown Simon S Mole Damian J DJ

Frontline gastroenterology 20151214 1

<h4>Objective</h4>To determine the impact of a 'Hot Clinic' (HC) on emergency general surgery patient flow-through.<h4>Design</h4>Prospective service evaluation study.<h4>Setting</h4>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 24 h considered suitable for interim discharge while awaiting investigations and HC reassessment.<h4>Patients</h4>All patients with ...[more]

PMID: 28839885

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Project description:BackgroundThe population of persons seeking medical care is linguistically diverse in the United States. Language barriers can adversely affect a patient's ability to explain their symptoms. Among hospitalized patients, these barriers may lead to higher readmission rates and longer hospitalizations. Trained interpreters help overcome communication barriers; however, interpreter usage among patients is suboptimal.ObjectiveTo investigate differences among patients with limited English proficiency (LEP) in their length of stay (LOS) and 30-day readmission rate associated with their receiving professional interpretation at admission or discharge.DesignWe analyzed the rates of interpretation at admission and discharge of all LEP patients admitted to a tertiary care hospital over a three-year period. We calculated length of stay in days and as log of LOS. We also examined 30-day readmission. Using multivariable regression models, we explored differences among patients who received interpretation at admission, discharge, or both, controlling for patient characteristics, including age, illness severity, language, and gender.ParticipantsAll LEP patients admitted between May 1, 2004 and April 30, 2007.Main measuresLength of hospital stay as related to use of professional interpreters; readmission to the hospital within 30 days.Key resultsOf the 3071 patients included in the study, 39 % received language interpretation on both admission and discharge date. Patients who did not receive professional interpretation at admission or both admission/discharge had an increase in their LOS of between 0.75 and 1.47 days, compared to patients who had an interpreter on both day of admission and discharge (P<0.02). Patients receiving interpretation at admission and/or discharge were less likely than patients receiving no interpretation to be readmitted with 30 days.ConclusionsThe length of a hospital stay for LEP patients was significantly longer when professional interpreters were not used at admission or both admission/discharge.

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Dataset Information

Emergency general surgery 'Hot Clinics' reduce admission rates and duration of inpatient stay.

Objective

Design

Setting

Patients

Intervention

Main outcome measures

Results

Conclusions

Publications

Emergency general surgery 'Hot Clinics' reduce admission rates and duration of inpatient stay.

Similar Datasets

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