AB148. SOH21AS102. Do surgical discharges from the emergency department receive the intended follow up?
General Poster Session

AB148. SOH21AS102. Do surgical discharges from the emergency department receive the intended follow up?

Gillian Cotter, Claire Donohoe

Department of Surgery, St. James’s Hospital, Dublin, Ireland

Background: General surgical review of patients presenting to the Emergency Department (ED) results in one key clinical decision: should this patient be admitted or discharged. Of the patients surgically discharged, a proportion will have a follow up plan comprising an outpatient (OPD) appointment, imaging or endoscopy. Failure of this follow up to occur results in missed opportunities for patient review, impacting both patient safety and satisfaction. The internal standard we aim for is 95% patients receiving follow up as planned upon discharge from ED. The goal of this audit was to review the current practice for arranging surgical follow up.

Methods: Patients presenting to the ED from 1/7/20 to 1/10/20, referred to General Surgery and then discharged without admission were audited. Data collection included surgical sign out documentation, electronic patient records, and the local patient booking system.

Results: Eighty-nine patients were surgically reviewed and subsequently discharged from the ED, with 63% of these having documented follow up stated in the surgical sign out. 20% patients were assigned multi-modality follow up. 87% OPD appointments, 100% imaging and 75% endoscopic investigations were appropriately booked. Of these, 88% OPD appointments, 15% imaging and 77% endoscopies were carried out.

Conclusions: To achieve follow up occurrence rates of 95%, we have created a set of guidelines to standardise the arrangement of follow up planning for patients who are surgically discharged from the ED. We also recommend that all patients in this cohort receive an OPD appointment, in person or virtual. We will re-audit in a 3-month cycle post implementation to assess potential system improvement and determine the sustainability of same.

Keywords: Discharge; emergency; follow up; general surgery; surgical review


Funding: None.


Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-21-ab148
Cite this abstract as: Cotter G, Donohoe C. SOH21AS102. Do surgical discharges from the emergency department receive the intended follow up? Mesentery Peritoneum 2021;5:AB148.

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