Is ‘hot clinic’ a ‘hot’ idea for evaluating emergency surgical admissions?

Javed, Muhammad Ahsan; Hall, Bethany; Young, Sahra; Scarfe, Danielle; Sharma, Ajay; Ashraf, S.

doi:10.1016/j.ijsu.2011.07.173

Cited by 2 publications

(1 citation statement)

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“…The General Surgery Department in the RIE cares for adults and teenagers aged 13 years and older. In NHS Lothian, approximately 11% of ED attendances are surgically related 13. In 2013/2014, there were 25 645 general surgery episodes (excluding vascular surgery) throughout NHS Lothian, of which 42% (n=10 858 episodes) were recorded as emergency inpatients 4.…”

Section: Methodsmentioning

confidence: 99%

Emergency general surgery ‘Hot Clinics’ reduce admission rates and duration of inpatient stay

Th’ng

Skouras

Paterson-Brown

et al. 2015

Frontline Gastroenterol

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ObjectiveTo determine the impact of a ‘Hot Clinic’ (HC) on emergency general surgery patient flow-through.DesignProspective service evaluation study.SettingHC 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.PatientsAll 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.InterventionIntroduction of consultant-led surgical HC every weekday afternoon.Main outcome measuresProportion of patients admitted under general surgeons, length of inpatient stay and the proportion of patients referred again within 3 months were investigated.Results1409 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).ConclusionsEmergency 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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Section: Methodsmentioning

confidence: 99%