You have accessJournal of UrologyCME1 Apr 2023MP72-10 UROLITHIASIS IN THE EMERGENCY DEPARTMENT: RESULTS OF A COLLABORATIVE QUALITY IMPROVEMENT PROJECT Kimberly Kocour, Eliza Defroda, Elizabeth Malm-Buatsi, Mark Wakefield, Chase Schlesselman, Katie Murray, and Geoffrey Rosen Kimberly KocourKimberly Kocour More articles by this author , Eliza DefrodaEliza Defroda More articles by this author , Elizabeth Malm-BuatsiElizabeth Malm-Buatsi More articles by this author , Mark WakefieldMark Wakefield More articles by this author , Chase SchlesselmanChase Schlesselman More articles by this author , Katie MurrayKatie Murray More articles by this author , and Geoffrey RosenGeoffrey Rosen More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003340.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Urolithiasis is a frequent cause for emergency department (ED) visits. For some, urology consults are indicated, while for many, outpatient follow up is appropriate. We noted an opportunity to improve care for patients with newly diagnosed urolithiasis in our ED. We completed a quality improvement project to improve patient triage and decrease time to follow up, with the hypothesis that the protocol would lead to fewer ED revisits and improved patient management. METHODS: We created the MU Pathway for Particularly Expeditious Treatment of Stones (MUPPETS) which couples an ED stone triage protocol with early urologic follow up. The protocol helped identify patients who did not need a urology consult. For these patients, a new follow-up order was created which scheduled patients for a urology visit (typically by phone) within 72 hours. After creation of the protocol, educational sessions were given to Urology and ED at our institution. We retrospectively reviewed ED visits with kidney or renal stone diagnoses where the patient was discharged from the ED. Chi-squared tests were used to compare outcomes in the first 30 days after the ED visit. RESULTS: Protocol was initiated in March 2022. We identified 546 patients in the pre-intervention period (Dec 2020-Feb 2022), and 269 patients in the post-intervention period (Apr-Sep 2022). Narcotic prescribing decreased after our education sessions (38% vs 30%, p=0.02, figure 1a). 137 patients had the follow up order placed. These patients were more likely to have urology follow-up (62% vs 15%, p<0.0001) and urological surgery (15% vs 8%, p=0.008) in the first 30 days than those with no order. Patients who completed a follow up visit according to the protocol were less likely to have an ED visit in the first 30 days than those who did not (25% vs 49%, p=0.0004, figure 1b). CONCLUSIONS: We developed a quality improvement intervention aimed at improving triage of patients with urolithiasis and ensuring prompt follow up for those discharged from the ED. Implementation of this protocol at our institution significantly improved time to evaluation and treatment, and decreased repeat ED visits. This collaborative effort of urology and ED has the potential to improve patient care most importantly, but in turn could decrease unnecessary health care costs and narcotic use in urolithiasis. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1028 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kimberly Kocour More articles by this author Eliza Defroda More articles by this author Elizabeth Malm-Buatsi More articles by this author Mark Wakefield More articles by this author Chase Schlesselman More articles by this author Katie Murray More articles by this author Geoffrey Rosen More articles by this author Expand All Advertisement PDF downloadLoading ...