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Entrance to the emergency room of the Royal Columbian Hospital.
Although Dr. McDonald stated that the study had been conducted on patients who had been hospitalized at the Chilliwack Hospital, she thinks the results can be applied more generally.
Ward Perrin / PROVINCE
Postoperative visits to the emergency department are quite common, with just over 15% of patients going to the emergency department of a hospital within six weeks of surgery, regardless of their type of operation. . study shows.
The most common complaints and diagnoses were pains related to surgery, infections and bleeding, according to the cover study published in British Columbia. Medical journal.
Dr. Susan McDonald, co-author of the study, said that as more and more patients are released on the same day as their operations, they lose all the attention and training they receive from nurses. This loss of postoperative control has increased the likelihood that patients will experience problems or complications after they leave the hospital.
McDonald, a general surgeon at Chilliwack General Hospital, said some surgeons are telling patients to return for a follow-up two to three weeks after their operation, while others plan six weeks. this is often due to the complexity of the procedure. But patients often feel that they can not wait any longer for problems.
The finding that 15.1% of patients who have had surgery go to the emergency department in the weeks following the operation suggests that quality improvement measures are needed, McDonald said. She urged the Fraser Health Authority, for example, to immediately inform surgeons of the reinstatement of one of their patients to the hospital. But she said health authorities needed to find a workaround to change how computerized hospital records are formatted so surgeons can receive such notifications whenever one of their patients presents a postoperative problem.
"As a surgeon, I want to be notified of patients with complications. I can not fix what I do not know, "said McDonald. "Surgeons also need this information for their personal learning. It's discouraging when patients develop infections. They lose confidence in their doctors and in the system. "
She added that patients also needed to ask more questions, receive more information as part of their informed consent process, and be urged to read and keep the leaflets distributed to them to find out what they were doing. Wait after the surgery.
The study was based on diagrams – marked with a red dot for the purposes of the study – from about 250 postoperative patients who visited the Chilliwack Hospital at the summer of 2015.
Of this total, just over half were operated in this hospital, the others operated in other hospitals. Only two patients who went to the emergency department had to be hospitalized, while the others were prescribed antibiotics, other drugs or some form of treatment.
McDonald said that although the study was done on patients who went to the Chilliwack Hospital, she thinks the results can be applied more generally.
"Few studies have been published on this approach. Most studies look at specific diseases or procedures, then look to the past to determine the rate of emergency visits. But I think we were very close to the figures quoted in these few other studies. "
The message for patients and doctors is that communication is of paramount importance, she said. If anticipated or even unforeseen problems are not covered during consultations with surgeons, patients should know what to expect, including the extent of pain and discomfort that may be expected. , since any surgical procedure involves some pain. Patients should also have discussions with doctors about who to see and where to go if they have problems so that emergency services are not necessarily the default destination for visits that are not real emergencies.
But Mr McDonald admits that it is likely that the growing number of patients without a primary care physician is contributing to a high number of patients using emergencies.
"Almost 30% of Chilliwack patients do not have a family doctor. This is definitely something that concerns me now and that may well explain why people go to the emergency room. "
Ms. McDonald said that an ideal scenario would involve emergency doctors calling surgeons when their patients go to the ER, but she knows that they are usually too busy to do it, let alone their reluctance to call them late at night or on weekends.
"The emergency doctors are great, they do their best, but they are overworked. Nevertheless, it is a problem related to the need for better communication. Therefore, no one should be afraid to pick up the phone or warn surgeons who might want to know what the problem is and how to fix it. "
McDonald said that further research deepens the data.
A few months ago, another B.C. study showed that this province has the second highest rate of readmission to the hospital in the country. Readmission rates in hospitals mark the performance of the health system and significantly increase costs for hospitals.
The national average of urgent and unexpected readmissions for medical conditions such as mental health problems, cancer, heart failure and chronic obstructive pulmonary disease is 9.1%. But the BC 9.6%, while Saskatchewan has the highest rate – 9.9%.
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