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How Long Does it Take to Diagnose Appendicitis? Time Point Process Mapping in the Emergency Department

Paulette I Abbas, Irving J Zamora, Simone C Elder

  • 1E. B. Singleton Department of Pediatric Radiology, Texas Children's Hospital.

Pediatric Emergency Care
|June 1, 2018
PubMed

Insights

A new ultrasound scoring system for pediatric appendicitis did not significantly change emergency department wait times or overall patient flow. Further interventions are needed to improve efficiency in evaluating children with suspected appendicitis.

Area of Science:

  • Pediatric Emergency Medicine
  • Diagnostic Imaging
  • Surgical Emergencies

Background:

  • Appendicitis is a common surgical emergency in pediatric emergency departments.
  • Efficient evaluation is crucial for timely treatment and improved patient outcomes.

Purpose of the Study:

  • To evaluate the impact of a novel risk-stratified ultrasound scoring system (Appy-Score) on the time course of pediatric appendicitis evaluation.
  • To assess changes in emergency department process flow after implementation of the Appy-Score.

Main Methods:

  • Retrospective review of pediatric patients (age ≤18 years) evaluated for suspected appendicitis.
  • Comparison of evaluation times before and after implementation of the Appy-Score (July 2013).
  • Analysis included time from ultrasound order to read, disposition, operating room posting, and overall emergency department stay.

Main Results:

  • No significant differences were observed in key time metrics between the pre- and post-implementation periods.
  • Times for ultrasound to first read, ultrasound to disposition, and operating room posting remained statistically similar.
  • Overall emergency department stay duration was also unaffected by the new scoring system.

Conclusions:

  • The Appy-Score, while standardizing reporting, did not significantly improve emergency department process flow for pediatric appendicitis.
  • Complexities in emergency department throughput require multifaceted solutions beyond a single scoring system.
  • Additional factors need to be addressed to optimize patient flow for appendicitis evaluation.
Abstract

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