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DOI: 10.1055/s-0038-1637039
PROVISION OF AN 8AM GI BLEED SERVICE – IS THERE SCOPE FOR IMPROVEMENT? A DISTRICT GENERAL HOSPITAL EXPERIENCE IN UNITED KINGDOM
Publication History
Publication Date:
27 March 2018 (online)
Aims:
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To assess the utility of two daily 8am, pre-working hours weekday endoscopy slots, dedicated to patients presenting with Acute Upper Gastrointestinal Bleed (AUGIB), in conjunction with the local AUGIB service
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To assess efficacy of these in improving compliance towards national guidelines
Methods:
Retrospective data collection over a 2 month period of all inpatient oesophago-gastro duodenoscopies (OGDs) done at Ipswich Hospital in 8am slots and working hours (excluding weekends). Potential AUGIB were identified by indications of haematemesis, melaena or ‘coffee-ground’ vomiting. Date and time of referrals and procedures were recorded.
Results:
Most AUGIB cases (58/59) had an OGD within 24 hours of admission. 62% (36/58) of these were done in the 8am slots.
Out of 86 8am slots, 16.2% (14/86) were not filled. 50% of OGDs done in the rest of the 8am slots were not potential AUGIB cases.
23 AUGIB cases were done during working hours, 4 of which could have been done in the next available 8am slot as they were unfilled. 63.2% (12/19) of the other cases could have been prioritised to the next available 8am slots instead of a non-AUGIB case that had filled the slot.
Referrals for 43.5% (10/23) of these AUGIB cases were placed out of hours, 7 of which could have been done in the next available 8am slots.
Conclusions:
8am endoscopy slots have improved our AUGIB service provision, with almost full compliance towards national guidelines of offering endoscopy for patients presenting with suspected AUGIB within 24 hours of admission. However, various areas need to be addressed to maximise utility of the 8am slots. This includes continued education to endoscopy nurses vetting referrals and education of the local AUGIB referral pathway during annual junior doctor hospital induction.