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MEDTECH Patient-Facing Emergency Pathway for General Surgery Works Well During Pandemic
A recent study discussed at the 2023 annual meeting of the Surgical Infection Society revealed the potential of a new ER-to-OR pathway in reducing inpatient admissions, particularly during healthcare system stress times like the COVID-19 pandemic.
Key Points:
- A new ER-to-OR pathway was implemented for patients with acute appendicitis and acute cholecystitis.
- The study comprised 166 patients over four months.
- The median length of stay (LOS) in the ED was 9.4 hours, and in the clinical decision unit, it was 5.9 hours.
- Only 19% of the patients were admitted post-operatively.
- The overall readmission rate within 30 days was 3%.
- 81% of patients in the pathway avoided hospital admission.
Additional Points:
- Patients with cholecystitis had longer stays in the ED and clinical decision unit than those with appendicitis.
- Of the patients discharged from the PACU, only 1.5% were readmitted within 30 days.
- The researchers plan to compare these results with a historical cohort to measure the pathway’s true impact.
- The financial implications of this pathway could include accepting more transfers, treating more patients, and decreasing costs for patients.
- The study limitations include a short study period, lack of a historical cohort, variability in discharge rates among providers, and patient consultation exclusions.
Conclusion:
- Despite certain limitations, the ER-to-OR pathway offers a promising solution to reduce inpatient admissions for acute appendicitis and cholecystitis, particularly during periods of healthcare system stress, as evidenced during the COVID-19 pandemic.
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“The potential financial implications of this pathway include the possibility of accepting more inter-facility transfers, treating more patients and decreasing costs for patients by spending less time in the hospital system”
Husayn Ladhani, MD
General Surgery Specialist & Lead Study Author
Denver Health Medical Center
