Abstract Aim With increased bed pressures due to COVID-19, keeping patients out of hospital became critical. Computed Tomography (CT) utilisation was increased to aid in the assessment of acute surgical patients. The aim of this study was to assess if increased access to CT reduced inpatient admissions. Methods A Retrospective audit of patients presenting to the Emergency Department (ED) between 12th July – 23rd August 2020 who required a CT scan. Data collected from Electronic Care Records and NIPACS, including patient destination at time of CT and decision following CT. For comparison, the same time-period in 2019 was assessed. Results In 2020, 301 patients required a CT compared to 207 in 2019. 84.7% (255/301) had a CT direct from ED in 2020 vs. 56.5% (117/207) in 2019 (p < 0.001). Of those who had CT direct from ED in 2020 18.4% (47/255) were discharged, compared to 1.7% (2/117) in 2019 (p < 0.001). 9.8% (25/255) were directed to an alternative specialty in 2020 vs. 2.6% (3/117) in 2019 (p = 0.014). 2.7% (8/301) were discharged for an ambulatory CT in 2020, an increase from 0.5% (1/207) in 2019 (p = 0.07). Overall, there was a 24% reduction in the number of patients requiring acute surgical admission in 2020 vs. 2019. Conclusions There was a significant increase in the number of CT’s carried out directly from ED. This enabled a significant number of patients to be discharged or transferred to a more appropriate specialty. These results demonstrate that increased access to CT can reduce the need for acute surgical admission.
Abstract Aim With the increased need to manage patients out of hospital during COVID-19, it was anticipated that need for ambulatory imaging would increase. This study aimed to assess the demand for ambulatory ultrasounds (US) during the COVID-19 pandemic and the impact on inpatient admissions. Methods A retrospective review of patients presenting to the Emergency Department (ED) between 12th July – 23rd August 2020 who required an US as first line imaging. Electronic Care Records were used to collect data regarding type of US i.e., inpatient, or ambulatory, time taken for ambulatory US and outcome after imaging. The same period in 2019 was assessed for comparison. Results In 2020, 100 patients required an US compared to 88 in 2019. 37% (37/100) of which were discharged for an ambulatory US, compared to 14.8% (13/88) in 2019 (p = 0.006). The average waiting time for an ambulatory US in 2019 was 2 days, this increased to 7 days in 2020. Following ambulatory US in 2020 43.2% (16/37) required further outpatient imaging or assessment; similar outcomes were seen in 2019 with 46.2% (6/13). Overall, there was a 150% increase in the use of ambulatory US, with a 26% decrease in admissions in 2020 vs. 2019. Conclusions There was a significant increase in the number of patients discharged from ED to undergo an ambulatory US resulting in reduced inpatient admissions. This increase in demand is reflected by the prolonged waiting time highlighting the requirement for expansion of ambulatory services to meet this clinical need.
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