A236 UTILIZATION OF AN URGENT GASTROENTEROLOGY CLINIC FOR PATIENTS SEEN IN THE EMERGENCY ROOM OR URGENT CARE CENTRE

Autor: Kelvin K.F. Tsoi, Subhas C. Ganguli, Khurram J. Khan, W Kabir, R Spaziani, S. Jalali, H Fergani, David Morgan
Rok vydání: 2018
Předmět:
Zdroj: Journal of the Canadian Association of Gastroenterology. 1:346-346
ISSN: 2515-2092
2515-2084
Popis: BACKGROUND: The Canadian Association of Gastroenterology reports that wait times to see a gastroenterologist are too long, even for urgent problems. To improve timely access for patients, a dedicated urgent GI clinic started at St Joseph’s Healthcare Hamilton in March 2014. The clinic accepted referrals from the emergency room (ER) and urgent care clinic with a capacity of 6 patients per week booked within 3 weeks of referral. Suggested referral criteria included a) subacute GI bleeding b) progressive dysphagia c) suspected diagnosis of IBD based on imaging/results and other reasons including liver diseases. AIMS: To review the utility of the clinic, appropriateness of referrals, and utilization of endoscopy resources to guide any necessary changes to the clinic. METHODS: Retrospective review of all cases that were seen in the urgent GI clinic to identify demographic factors, reasons for referrals, duration of symptoms, whether they had previously seen a gastroenterologist, utilization of endoscopy resources and requirement for ongoing follow up. RESULTS: Between March and October 2014, 119 patients were seen in the urgent GI clinic and 118 were reviewed. An average of 4.5 patients was seen per clinic out of 6 allocated spots giving a missed appointment rate of 25%. The average age of the patient was 52.9 years, and 57% were females. The mean duration of symptoms was 23.4 weeks, but 59% of patients had more acute symptoms for 1 week or less when presenting to ER or urgent care. The most common reasons for referrals included lower GI bleeding (31%), abdominal pain (25%), upper GI bleeding (13%), anemia (5%), and dysphagia (3%). Of the 119 patients, 42% had previously seen a gastroenterologist, and 46% had recently visited the ER or urgent care. A high proportion (71%) was booked for endoscopic tests after the consultation, and 52% were booked for a follow-up appointment. CONCLUSIONS: The urgent clinic provides a useful mechanism to see subacute GI illnesses in a timely fashion. However, further optimization is needed to reduce incidence of missed appointments, seeing patients already under care of a gastroenterologist, and referrals for chronic GI illness. There are challenges in high endoscopy utilization and clinic follow-up associated with this strategy. Longer studies may help illustrate further benefits of healthcare utilization by examining reduction in recurrent visits to ER or urgent care. FUNDING AGENCIES: None
Databáze: OpenAIRE
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