Establishment of Emergency Surgery Triage and Checklist Management System

Overview

The goal of this observational study is to develop and test a system for managing emergency surgery patients at Beijing Union Medical College Hospital. The main questions it aims to answer are: What information is necessary for effective patient triage and handovers between the emergency department, anesthesia, and ICU for surgical patients? How effective and feasible is a standardized handover process in improving patient outcomes and safety? Participants will: Be observed and have their handovers documented to identify key information required. Participate in implementing a new handover checklist and triage system. Researchers will compare the periods before and after implementing the new system to see if it: Reduces missed critical information during handovers. Decreases pre-surgery waiting times for critically ill patients. Improves overall patient safety and outcomes, including reducing postoperative complications, mortality rates, length of hospital stay, and medical costs.

The study will be conducted in several phases to establish a comprehensive emergency surgery triage and checklist management system at Beijing Union Medical College Hospital. Phase 1: Literature Review and Initial Assessment First, a comprehensive review of existing literature and past emergency surgery cases will be conducted to identify common issues and best practices. Phase 2: Expert Panel and Delphi Process An expert panel consisting of hospital management staff, anesthesiologists, emergency surgeons, ICU intensivists, and ER doctors will be formed. This panel will engage in a Delphi process to discuss and develop a standardized system for managing emergency surgery patients. Phase 3: System Implementation and Testing The newly developed system will be implemented and tested. Key metrics to be documented, evaluated, and compared include: The number of omitted information items during the emergency-anesthesia handover. Staff satisfaction with the new handover process across the emergency department, general surgery, anesthesia, and ICU. In-hospital mortality rate after surgery. Postoperative in-hospital complications, classified by Clavien-Dindo grading, and their incidence rate. Patient waiting times, including time to theatre and time to incision. Duration of the handover process. Incidence of follow-up calls to inquire about additional information after the handover. Phase 4: Evaluation and Comparison The effectiveness and feasibility of the new system will be evaluated by comparing the collected data before and after its implementation. This comparison will help determine the system\'s impact on improving patient outcomes, safety, and staff efficiency. By systematically addressing the critical points of patient handovers and emergency surgery management, this study aims to enhance overall healthcare quality and patient safety in emergency surgical settings.