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[Assessment of a post-emergency pathway with early urological regulation]
I Bentellis1, F Colomb2, M Drogrey3
1Service d'urologie, hôpital Pasteur-2, CHU de Nice, université de Nice-Sophia Antipolis, 30, voie Romaine, 06000 Nice, France.
Insights
A post-emergency urology consultation (CPU) effectively managed 76% of urgent cases. Identifying no-show patients helped target at-risk groups for improved urological emergency care.
Area of Science:
- Urology
- Emergency Medicine
- Healthcare Management
Background:
- Urological emergencies constitute 7% of emergency department (ED) visits.
- The study evaluates the impact of a post-emergency consultation (CPU) following initial urological assessment and regulation.
Purpose of the Study:
- To assess the effectiveness of a post-emergency consultation (CPU) in managing patients with urological emergencies.
- To identify factors influencing the efficacy of the CPU, including patient follow-up and reasons for consultation.
Main Methods:
- A cohort of 128 patients admitted to an ED with scheduled CPUs between December 2017 and July 2018 was analyzed.
- The primary outcome measured was the CPU's ability to provide an efficient, predefined solution.
- Data on patient demographics, consultation reasons, and follow-up outcomes were collected.
Main Results:
- The CPU demonstrated an overall efficacy rate of 76%.
- Efficacy was significantly lower (47%) for patients who did not show up for their appointments or presented with rare/complex conditions.
- Only 6.9% of all ED urology consultations were referred to the CPU, with most decisions involving a second consultation (70%) or deferred surgery (12%).
Conclusions:
- A post-emergency urology consultation, when implemented after early regulation by a urologist, offers an effective management pathway in 76% of cases.
- Analysis of 'no-show' patients identified specific groups at higher risk, suggesting potential areas for intervention to improve care continuity.
Introduction:
Urological emergencies represent 7 % of the outpatients at the emergency department (ED). We assessed the effect of setting up a post-emergency consultation (CPU) after deferred urological medical regulation.
Methods:
All patients admitted to the ED in a university center over the period December 2017 to July 2018 and for whom a CPU was scheduled were included. The regulation concerned the date of CPU and supplementary exams. The main outcome was the ability to provide an efficient response according to a predefined grid of specific solutions.
Results:
One hundred and twenty-eight patients were included. The median age was 57 years (18-97). Efficacy of the CPU was 76 %. This rate was lower in no-show patients or consulting for rare and complex motives (47 %, n=60). The no-show were not reachable on the first call in 51.6 % of cases, with a similar age and motives distribution to the others. Only 6,9 % (n=128) of all consultants (n=1863) had been referred to the CPU by emergency physicians. The decision was a second consultation in 70 % (48), a new exam in 10 % (7), deferred emergency surgery in 12 % (8) and finally 18 % (12) of no follow-up.
Conclusion:
CPU following early regulation by a urologist provides an effective response in 76 % of situations. Assessment of "no-shows" helped to identify groups at risk.
Level Of Evidence:
III.
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