Wieren, M. van (Max) (2021) Vervroegd aanvragen van de echografie bij patienten met een verdenking appendicitis reduceert de tijd tot echografie maar niet per definitie de SEH-doorlooptijd. thesis, Medicine.
Full text available on request.Abstract
Introduction: Patient crowding is a problem in emergency departments (ED’s) worldwide. In recent years, there has been a lack of success in tackling this problem. Therefore, it is important to come up with novel solutions. Acute appendicitis might be interesting to find a novel solution because it’s the most common urgent diagnosis in patients with acute abdominal pain. By making the diagnostic process for these patients more efficient, the throughput of these patients might be improved and it may reduce patient crowding as well. Method: For this purpose, a retrospective pre- and post-implementation study is carried out on patients referred by the GP to the ED with suspected appendicitis. Therefore, the ultrasound was ordered after the hospital laboratory results came in for patients treated pre-implementation. And, the ultrasound was ordered earlier by using the C-reactive protein (CRP) via Point of Care Testing (POCT) provided by the GP for patients treated post-implementation. This is done to get insight in whether the ED length of stay (LOS) and time to ultrasound in the post-implementation cohort would reduce. Besides that, sub-analyses are made of patients who were discharged and admitted. Results: There were 44 patients included in the study of whom 21 pre- and 23 post-implementation. In the post-implementation cohort, the ultrasound was performed 27 minutes earlier (P = 0.02) and the ED LOS was 4 minutes shorter (P = 0.307). Among patients discharged, the ED LOS decreased by 74 minutes in the post-implementation cohort (P = 0.065). In contrast, among patients who were admitted the ED LOS increased by 50 minutes in the post-implementation cohort (P = 0.275). Conclusion: Early request for ultrasound based on POCT CRP by the GP affects the time to ultrasound but seems to have a minor impact on the ED LOS. However, there seems to be a benefit on ED LOS for people discharged after treatment in the ED.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Heide, drs. K. van der |
| Faculty: | Medical Sciences |
| Date Deposited: | 05 Jan 2022 11:22 |
| Last Modified: | 05 Jan 2022 11:22 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2947 |
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