Healthcare Commissioning Forum
QIPP => Elective Admission Reduction => Topic started by: Laxmikant Tyagi on May 11, 2015, 11:11:37 am
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What are the risks involved for early detection of Low risk upper gastrointestinal bleeding patients?
Because all patients not admitted had an outpatient endoscopy arranged, we attempted to ensure we did not miss any significant pathology.
Prospective audit of this management plan in Glasgow and Stockton revealed that no patients came to harm from this approach. As mentioned, patients were discharged with a plan for outpatient endoscopy but only 40% attended. Of the patients who did not attend for outpatient endoscopy, the individual GPs were contacted and the patient’s record examined for evidence of adverse consultation behaviour related to GI bleeding or other related events. None was identified. It is important to emphasise that a protocol be implemented with a strategy to offer outpatient endoscopy to the low -risk upper GI haemorrhage patient who is not admitted.
As indicated, recent publications and data from other centres in Asia and the USA have concurred that patients with a GBS = 0 are suitable for outpatient management due to their extremely low risk of requiring hospital-based intervention.
For further information: https://arms.evidence.nhs.uk/resources/qipp/29482/attachment