The implementation of a protected emergency theatre pathway for acute urological admissions

A systematic review of dedicated models of care for emergency urological patients

“…After removal of 210 duplicate results and 631 irrelevant studies, 16 articles were retrieved for full-text review ( Appendix 1 ). From these, seven eligible publications were selected, totaling 487 patients [ [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] ] ( Table 1 ). However, this sum represents an under-estimate, with three studies reporting samples of undefined size.…”

“… -Consultant & theatre rostered all day to elective duties -A consultant rostered solely to EUPs, & 3 half-day EUP theatre lists/week – – – – – – – ¶ †† – 2017 Narra [ 28 ] Australia Surgery Prosp. -No dedicated EUP theatre lists -2 half-day EUP theatre lists/week – 8 – 70 NA – – – ‡‡ 2 2018 Hegazy [ 29 ] Ireland Urolithiasis Prosp. -No EUP pathways & limited emergency theatre capacity -Specified EUP pathways & increased emergency theatre capacity 2 ∫ 2 ∫ 58 ∫ 58 ∫ – Δ 56 to 13 Δ 5.2 to 2.8 – – 7 ED, emergency department; EUP, emergency urological patients; Interv., intervention group; LOS, change in mean length of stay; p.a., per annum; Prosp., prospective; Retro., retrospective; SAU, Surgical Assessment Unit; Trad., traditional group; TTT, change in mean time to theatre; UK, United Kingdom; NA, not applicable.…”

“…Two included studies were non-comparative case series of patients following introduction of dedicated emergency urological services [ 24 , 28 ], while the remaining five were comparative cohort studies, describing patient groups before and after such changes [ [25] , [26] , [27] , 29 , 30 ]. Four studies were prospective [ 24 , [28] , [29] , [30] ], and three retrospective [ [25] , [26] , [27] ]. There was a substantial disparity in the studies’ chosen enrolment moment within the patient journey.…”

“…There was a substantial disparity in the studies’ chosen enrolment moment within the patient journey. Two studies each assessed EUPs who had either presented to the emergency department [ 24 , 27 ], been admitted [ 25 , 30 ] or proceeded to the theatre [ 26 , 28 ], while one study assessed those with symptomatic renal calculi requiring surgery [ 29 ]. Similarly, patient enrolment period varied from 2 to 24 months [ [24] , [25] , [26] , 28 , 30 ], with two studies not reporting duration [ 27 , 29 ].…”

“…Raza et al. [ 26 ] described amending rosters to provide an full day urology registrar for emergency patients, while two other studies introduced protected emergency urology operating theatre access of either two half-day lists per week or unspecified quantity [ 28 , 29 ]. The commencement of a Surgical Assessment Unit was documented by Nican et al.…”