A systematic review of dedicated models of care for emergency urological patients
| Autor: | James Moore, Christopher Dobbins, Matheesha Herath, Derek Hennessey, Tarik Sammour, Dylan Barnett, Ned Kinnear |
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| Rok vydání: | 2021 |
| Předmět: |
Medical staff
Operating theatres Urology Acute care surgery 030232 urology & nephrology MEDLINE Acute surgical unit Review Acute 03 medical and health sciences Dedicated 0302 clinical medicine Primary outcome Rapid access Medicine business.industry Grey literature Hospital cost Emergency department medicine.disease Diseases of the genitourinary system. Urology 030220 oncology & carcinogenesis Emergency RC870-923 Medical emergency business |
| Zdroj: | Asian Journal of Urology, Vol 8, Iss 3, Pp 315-323 (2021) Asian Journal of Urology |
| ISSN: | 2214-3882 |
| DOI: | 10.1016/j.ajur.2020.06.006 |
| Popis: | Objective To systematically evaluate the spectrum of models providing dedicated resources for emergency urological patients (EUPs). Methods A search of Cochrane, Embase, Medline and grey literature from January 1, 2000 to March 26, 2019 was performed using methods pre-published on PROSPERO. Reporting followed Preferred Reporting Items for Systematic Review and meta-analysis guidelines. Eligible studies were articles or abstracts published in English describing dedicated models of care for EUPs, which reported at least one secondary outcome. Studies were excluded if they examined pathways dedicated only to single presentations, such as torsion, or outpatient solutions, such as rapid access clinics. The primary outcome was the spectrum of models. Secondary outcomes were time-to-theatre, length of stay, complications and cost. Results Seven studies were identified, totalling 487 patients. Six studies were conference abstracts, while one study was of full-text length but published in grey literature. Four distinct models were described. These included consultant urologists allocated solely to the care of EUPs (“Acute Urological Unit”) or dedicated registrars or operating theatres (“Hybrid structures”). In some services, EUPs bypassed emergency department assessment and were referred directly to urology (“Urological Assessment Unit”) or were managed by other dedicated means. Allocating services to EUPs was associated with reduced time-to-theatre, length of stay and hospital cost, and improved supervision of junior medical staff. Conclusion Multiple dedicated models of care exist for EUPs. Low-level evidence suggests these may improve outcomes for patients, staff and hospitals. Higher quality studies are required to explore patient outcomes and minimum requirements to establish these models. |
| Databáze: | OpenAIRE |
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