A systematic review of dedicated models of care for emergency urological patients
Objective: To systematically evaluate the spectrum of models providing dedicated resources for emergency urological patients (EUPs). Methods: A search of Cochrane, Embase, Medline and grey literature from January 1, 2000 to March 26, 2019 was performed using methods pre-published on PROSPERO. Report...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2021-07-01
|
| Series: | Asian Journal of Urology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214388220300552 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849324526058340352 |
|---|---|
| author | Ned Kinnear Matheesha Herath Dylan Barnett Derek Hennessey Christopher Dobbins Tarik Sammour James Moore |
| author_facet | Ned Kinnear Matheesha Herath Dylan Barnett Derek Hennessey Christopher Dobbins Tarik Sammour James Moore |
| author_sort | Ned Kinnear |
| collection | DOAJ |
| description | Objective: To systematically evaluate the spectrum of models providing dedicated resources for emergency urological patients (EUPs). Methods: A search of Cochrane, Embase, Medline and grey literature from January 1, 2000 to March 26, 2019 was performed using methods pre-published on PROSPERO. Reporting followed Preferred Reporting Items for Systematic Review and meta-analysis guidelines. Eligible studies were articles or abstracts published in English describing dedicated models of care for EUPs, which reported at least one secondary outcome. Studies were excluded if they examined pathways dedicated only to single presentations, such as torsion, or outpatient solutions, such as rapid access clinics. The primary outcome was the spectrum of models. Secondary outcomes were time-to-theatre, length of stay, complications and cost. Results: Seven studies were identified, totalling 487 patients. Six studies were conference abstracts, while one study was of full-text length but published in grey literature. Four distinct models were described. These included consultant urologists allocated solely to the care of EUPs (“Acute Urological Unit”) or dedicated registrars or operating theatres (“Hybrid structures”). In some services, EUPs bypassed emergency department assessment and were referred directly to urology (“Urological Assessment Unit”) or were managed by other dedicated means. Allocating services to EUPs was associated with reduced time-to-theatre, length of stay and hospital cost, and improved supervision of junior medical staff. Conclusion: Multiple dedicated models of care exist for EUPs. Low-level evidence suggests these may improve outcomes for patients, staff and hospitals. Higher quality studies are required to explore patient outcomes and minimum requirements to establish these models. |
| format | Article |
| id | doaj-art-641c40df532f404a8d9a6a72483605bb |
| institution | Kabale University |
| issn | 2214-3882 |
| language | English |
| publishDate | 2021-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Urology |
| spelling | doaj-art-641c40df532f404a8d9a6a72483605bb2025-08-20T03:48:41ZengElsevierAsian Journal of Urology2214-38822021-07-018331532310.1016/j.ajur.2020.06.006A systematic review of dedicated models of care for emergency urological patientsNed Kinnear0Matheesha Herath1Dylan Barnett2Derek Hennessey3Christopher Dobbins4Tarik Sammour5James Moore6Discipline of Surgery, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia; Corresponding author.Department of Surgery, Royal Adelaide Hospital, Adelaide, AustraliaDepartment of Surgery, Royal Adelaide Hospital, Adelaide, AustraliaDepartment of Urology, Mercy University Hospital, Cork, IrelandDiscipline of Surgery, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, AustraliaDiscipline of Surgery, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia; Department of Surgery, Royal Adelaide Hospital, Adelaide, AustraliaDiscipline of Surgery, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia; Department of Surgery, Royal Adelaide Hospital, Adelaide, AustraliaObjective: To systematically evaluate the spectrum of models providing dedicated resources for emergency urological patients (EUPs). Methods: A search of Cochrane, Embase, Medline and grey literature from January 1, 2000 to March 26, 2019 was performed using methods pre-published on PROSPERO. Reporting followed Preferred Reporting Items for Systematic Review and meta-analysis guidelines. Eligible studies were articles or abstracts published in English describing dedicated models of care for EUPs, which reported at least one secondary outcome. Studies were excluded if they examined pathways dedicated only to single presentations, such as torsion, or outpatient solutions, such as rapid access clinics. The primary outcome was the spectrum of models. Secondary outcomes were time-to-theatre, length of stay, complications and cost. Results: Seven studies were identified, totalling 487 patients. Six studies were conference abstracts, while one study was of full-text length but published in grey literature. Four distinct models were described. These included consultant urologists allocated solely to the care of EUPs (“Acute Urological Unit”) or dedicated registrars or operating theatres (“Hybrid structures”). In some services, EUPs bypassed emergency department assessment and were referred directly to urology (“Urological Assessment Unit”) or were managed by other dedicated means. Allocating services to EUPs was associated with reduced time-to-theatre, length of stay and hospital cost, and improved supervision of junior medical staff. Conclusion: Multiple dedicated models of care exist for EUPs. Low-level evidence suggests these may improve outcomes for patients, staff and hospitals. Higher quality studies are required to explore patient outcomes and minimum requirements to establish these models.http://www.sciencedirect.com/science/article/pii/S2214388220300552Acute surgical unitAcute care surgeryUrologyEmergencyAcuteDedicated |
| spellingShingle | Ned Kinnear Matheesha Herath Dylan Barnett Derek Hennessey Christopher Dobbins Tarik Sammour James Moore A systematic review of dedicated models of care for emergency urological patients Asian Journal of Urology Acute surgical unit Acute care surgery Urology Emergency Acute Dedicated |
| title | A systematic review of dedicated models of care for emergency urological patients |
| title_full | A systematic review of dedicated models of care for emergency urological patients |
| title_fullStr | A systematic review of dedicated models of care for emergency urological patients |
| title_full_unstemmed | A systematic review of dedicated models of care for emergency urological patients |
| title_short | A systematic review of dedicated models of care for emergency urological patients |
| title_sort | systematic review of dedicated models of care for emergency urological patients |
| topic | Acute surgical unit Acute care surgery Urology Emergency Acute Dedicated |
| url | http://www.sciencedirect.com/science/article/pii/S2214388220300552 |
| work_keys_str_mv | AT nedkinnear asystematicreviewofdedicatedmodelsofcareforemergencyurologicalpatients AT matheeshaherath asystematicreviewofdedicatedmodelsofcareforemergencyurologicalpatients AT dylanbarnett asystematicreviewofdedicatedmodelsofcareforemergencyurologicalpatients AT derekhennessey asystematicreviewofdedicatedmodelsofcareforemergencyurologicalpatients AT christopherdobbins asystematicreviewofdedicatedmodelsofcareforemergencyurologicalpatients AT tariksammour asystematicreviewofdedicatedmodelsofcareforemergencyurologicalpatients AT jamesmoore asystematicreviewofdedicatedmodelsofcareforemergencyurologicalpatients AT nedkinnear systematicreviewofdedicatedmodelsofcareforemergencyurologicalpatients AT matheeshaherath systematicreviewofdedicatedmodelsofcareforemergencyurologicalpatients AT dylanbarnett systematicreviewofdedicatedmodelsofcareforemergencyurologicalpatients AT derekhennessey systematicreviewofdedicatedmodelsofcareforemergencyurologicalpatients AT christopherdobbins systematicreviewofdedicatedmodelsofcareforemergencyurologicalpatients AT tariksammour systematicreviewofdedicatedmodelsofcareforemergencyurologicalpatients AT jamesmoore systematicreviewofdedicatedmodelsofcareforemergencyurologicalpatients |