Abstract
Introduction At IRCCS San Martino Hospital of Genoa, Italy emergency and urgent surgery is classified according to the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) classification , assigning the relative colour-coded class, into two categories:
- EMERGENCY – (Colour-code class: RED) “Emergencies to be performed within minutes”.
- URGENCY – (colour-code class: YELLOW) "Urgencies to be performed within hours”. In this context, it is essential that the emergency surgical team gets clear and complete information from the proposal surgeon, in order to complete the surgical list. Method Between 14th April 2023 and 23th July 2023 a new method of communication, filling out an online form, was introduced for requests of urgent and emergency surgery. A three-months period of analysis and monitoring followed. Results: A total of 406 requests were filled, resulting in 367 E/U surgeries. The majority of all emergency operations were for thoracic-abdominal surgery (45%), followed by urology (19%). The requests analysed reported that 18% were classified as red, 71% as yellow. For the remaining 11% compilation errors were detected. Moreover, 11% of the interventions were not performed within the time limits defined according to the severity code. Conclusions: With the introduction of this new tool, the IRCCS San Martino Hospital’s Healthcare Management Unit may monitor the requests for intervention in real time, in order to achieve more efficiency and provide corrective actions in the use of the Operating Room resources.
References
References:
M. A. Coelho, P. L. Toledo de Arruda Lourencao, S. T. Weber, e E. V. Paiva Ortolan, «Implementation of a surgical screening system for urgent and emergent cases in a tertiary hospital.», Rev Col Bras Cir, 2019, doi: 10.1590/0100-6991e-20192211.
«NSW Emergency Surgery Guidelines and Principles for Improvement.», NSW Government, mag. 2021.
B. De Simone , Y. Kluger, E. E. Moore, M. Sartelli, F. M. Abu-Zidan, F. Coccolini, L. Ansaloni, G. D. Tebala, S. Di Saverio, I. Di Carlo, B. E. Sakakushev, L. Bonavina, M. Sugrue, J. M. Galante, R. Ivatury, E. Picetti, M. Chirica, I. Wani, M. Bala, I. Sall, A. W Kirkpatrick, V. G. Shelat, E. Pikoulis, A. Leppäniemi, E. Tan, R. P. G. ten Broek, S. Gurmu Beka, A. Litvin, E. Chouillard, R. Coimbra, Y. Cui, N. De’Angelis, G. Sganga, P. F. Stahel, V. Agnoletti, A. Rampini, WSES TACS panel of experts, M. Testini, F. Bravi, R. V. Maier, W.L. Biffl and F. Catena, «The new timing in acute care surgery (new TACS) classification: a WSES Delphi consensus study», World Journal of Emergency Surgery, 2023, doi: 10.1186/s13017-023-00499-3.
«The NCEPOD Classification of Intervention. Classification of Intervention. » Disponibile al l'indirizzo: https://www.ncepod.org.uk/classification.html, 2004.
A. Leppäniemi, I. Jousela«A trafficlight coding system to organize emergency surgery across surgical disciplines», 2013, doi: 10.1002/bjs.9325.
Y. Kluger, O. Ben-Ishay, M. Sartelli, L. Ansaloni, A. E. Abbas, F. Agresta, W. L. Biffl, L. Baiocchi, M. Bala, F. Catena, R. Coimbra, Y. Cui, S. Di Saverio, K. Das, T. El Zalabany, G. P Fraga, C. A. Gomes, R. A. Teixeira Gonsaga, J. Kenig, A. Leppäniemi, S. Marwah, G. Alves Pereira Junior, B. Sakakushev, B. Siribumrungwon, N. Sato, C. Tranà, N. Vettoretto and E. E. Moore26, «World society of emergency surgery study group initiative on Timing of Acute Care Surgery classification (TACS)», World Journal of Emergency Surgery, 2013, doi: 10.1186/1749-7922-8-17.
Masood Jawaid, Syed Muhammad Raza, Shams Nadeem Alam, and S Manzar, «On-call emergency workload of a general surgical team», J Emerg Trauma Shock, 2009, doi: 10.4103/0974-2700.44677.
V. Koivukangas, A. Saarela, S. Meriläinen, e H. Wiik, «How Well Planned Urgency Class Come True in The Emergency Surgery? Timing of Acute Care Surgery», Scand J Surg, 2020 doi: 10.1177/1457496919826716.
J. T. Van Essen, E. W. Hans, J. L. Hurink, e A. Oversberg, «Minimizing the waiting time for emergency surgery - Operations Research for Health Care, Volume 1, Issues 2–3, Pages 34-44», Operations Research for Health Care, 2012.
Coccolini F, Sartelli M, Kluger Y, Osipov A, Cui Y, Beka SG, Kirkpatrick A, Sall I, Moore EE, Biffl WL, Litvin A, Pisano M, Magnone S, Picetti E, de Angelis N, Stahel P, Ansaloni L, Tan E, Abu-Zidan F, Ceresoli M, Hecker A, Chiara O, Sganga G, Khokha V, di Saverio S, Sakakushev B, Campanelli G, Fraga G, Wani I, Broek RT, Cicuttin E, Cremonini C, Tartaglia D, Soreide K, Galante J, de Moya M, Koike K, De Simone B, Balogh Z, Amico F, Shelat V, Pikoulis E, Di Carlo I, Bonavina L, Leppaniemi A, Marzi I, Ivatury R, Khan J, Maier RV, Hardcastle TC, Isik A, Podda M, Tolonen M, Rasa K, Navsaria PH, Demetrashvili Z, Tarasconi A, Carcoforo P, Sibilla MG, Baiocchi GL, Pararas N, Weber D, Chiarugi M, Catena F., «The LIFE TRIAD of emergency general surgery», World Journal of Emergency Surgery, 2022, doi: 10.1186/s13017-022-00447-7.
T. E. Howe, I. Varley, J. E. Allen, A. Glossop, e A. McKechnie, «Scheduling terminology for oral and maxillofacial surgery. Are we speaking a universal language?», Br J Oral Maxillofac Surg, 2016, doi: 10.1016/j.bjoms.2016.10.025