Analyse d’un modèle de circuit court post-urgence avec une régulation précoce urologique

Abstract

Urological emergencies represent 7% of the outpatients at the emergency department (ED). We assessed the effect of setting up a post-emergency consultation (CPU) after deferred urological medical regulation. All patients admitted to the ED in a university center over the period December 2017to July 2018and for whom a CPU was scheduled were included. The regulation concerned the date of CPU and supplementary exams. The main outcome was the ability to provide an efficient response according to a predefined grid of specific solutions. One hundred and twenty-eight patients were included. The median age was 57years (18-97). Efficacy of the CPU was 76%. This rate was lower in no-show patients or consulting for rare and complex motives (47%, n=60). The no-show were not reachable on the first call in 51.6% of cases, with a similar age and motives distribution to the others. Only 6,9% (n=128) of all consultants (n=1863) had been referred to the CPU by emergency physicians. The decision was a second consultation in 70% (48), a new exam in 10% (7), deferred emergency surgery in 12% (8) and finally 18% (12) of no follow-up. CPU following early regulation by a urologist provides an effective response in 76% of situations. Assessment of "no-shows" helped to identify groups at risk. III.