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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
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Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
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Related Experiment Video

Updated: Mar 27, 2026

Optimizing Minimally Invasive Spine Surgery: A Fully 3D CT O-Arm Navigated Workflow in MIS TLIF
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Improving the surgical hot clinic.

Thomas Hubbard1, Rhys Thomas1

  • 1Croydon University Hospital, London.

BMJ Quality Improvement Reports
|January 7, 2016
PubMed
Summary

Developing ambulatory care for emergency surgery improves patient outcomes and resource management. Updated guidelines enhanced senior doctor involvement and GP communication, leading to safer, more effective care.

Area of Science:

  • Surgical Care
  • Healthcare Management
  • Quality Improvement

Background:

  • Ambulatory care is an underdeveloped concept in emergency surgery, despite increasing pressures on time and finances.
  • Effective risk management and communication with primary care providers are crucial for outpatient acute abdominal pain management.
  • Many institutions need to develop ambulatory services to manage increasing healthcare demands.

Purpose of the Study:

  • To identify current ambulatory care provision for surgical patients in a hospital's hot clinic.
  • To consult with the surgical department to pinpoint issues with patient throughput.
  • To update guidelines and improve the ambulatory hot clinic service.

Main Methods:

  • A quality improvement project was conducted at Croydon University Hospital's hot clinic.

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  • Current service provision was assessed, and surgical department consultations identified problems.
  • Guidelines were updated, validated by the general surgery department, and implemented.
  • Main Results:

    • Senior house officer-led assessments decreased from 26% to 9% (64% reduction), indicating increased registrar/consultant involvement.
    • Effective discharge liaison to General Practitioners (GPs) increased from 18% to 68% (250% rise).
    • The ambulatory hot clinic operated closer to full capacity post-intervention.

    Conclusions:

    • Updated guidelines resulted in a safer and more effective ambulatory hot clinic.
    • The improvements enhanced patient care for the local population.
    • The project demonstrated successful development of ambulatory care in emergency surgery.