N. Kulvatunyou1, B. Joseph1, S. Adikhari1, R. S. Friese1, L. Gries1, T. O’Keeffe1, A. L. Tang1, A. Jain1, G. Vercruysse1, N. Kulvatunyou1 1Banner-University Of Arizona,Trauma, Critical Care, Emergency General Surgery,Tucson, AZ, USA
Background: Efficient Emergency Department (ED) throughput depends on several factors, including the collaboration with surgical services. We, acute care surgery (ACS), collaborated with ED to implement this new process that we termed 'FASTPASS' which might improve patient-care process. The aim of this study was to evaluate 1-year outcome of the FASTPASS.
Methods: FASTPASS is a joint collaboration between ACS and ED. We provided ED physicians with a simple check-list for diagnosing young male (< 50-year old) with acute appendicitis (AA) and young male or female (< 50-year old) with gallbladder disease (GBD). Once ED deemed patients fit the check-list, patients got direct admitted (FASTPASS) to observation unit. The ACS then came to evaluate the patients for possible surgical intervention. We performed outcome analysis before and after institution of the FASTPASS. Outcomes of interest were ED length of stay (LOS), time from ED to operating room (OR), and hospital LOS (HLOS).
Results: During our 1-year study period, we were able to FASTPASS 56 (26%) GBD and 27 (26%) AA patients. When compared to non-FP patients, FP patients had shorter ED LOS, time from ED to OR, and shorter HLOS (Table), P < 0.001.
Conclusion: In this study, FP process helped streamline care process for a subset of patients with GBD and AA. For a future study, a larger sample size and an improvement in capture rate is needed.
