Emergency General Surgery Clinic Fast Track

Purpose (what): To bring patients to the emergency general surgery fast track hot clinic for immediate intervention for surgical care of abscess. Provides immediate care without presenting to emergency department.

Relevance/significance (why): Keeps patient from presenting to the emergency department with surgical need for I and D of abscess, immediate intervention in the ambulatory clinic space, increasing patient satisfaction containing resources with positive patient outcomes.

Strategy and implementation (how): A hot clinic pager was designated for the RNs in the emergency general surgery clinic (EGSC). The pager was used by the internal medicine clinics to page the EGSC nurse requesting a clinic room for patient with an abscess. Attending and or fellow nurses are paged to come to the clinic to access the patient. Patient is accessed, I and D is completed if necessary, antibiotics prescribed if deemed necessary, and instructions and education to patient for follow-up of care in the EGS clinic. Both the PCP visit and the EGSC visit happen on the same day.

Evaluation/outcome: From January 1, 2018, to September 30, 2018, a total of 136 patients were brought to the emergency general surgery clinic for abscess evaluation. That is a total of 136 patients that did not present in the emergency department. This is a collaborative effort with the emergency department, internal medicine clinics, and the emergency general surgery clinic to improve patient care with fewer resources and improved patient outcomes and patient satisfaction. Two of the 136 were taken to the main OR due to complications of their disease process without presenting to the emergency department. Of the two patients with complications, one had an abscess in breast tissue and the second patient was septic.

Implications for practice: Patient satisfaction with increased patient compliance for plan of care, reduced emergency room visits, and provided more positive outcomes with plan of care being implemented at time of assessment. Use of resources reduced with immediate intervention upon assessment.