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Same-Day Surgery Clinic: A model for improving access to care at academic medical centers

      Highlights

      • There is a lack of best-practice models for delivering outpatient surgical care.
      • Improving timely access to outpatient surgical care likely decreases ED utilization.
      • A Same-Day Surgery Clinic model improves community access to surgical care.
      • For surgical problems, surgeon-led imaging is superior in diagnosis and efficiency.

      Abstract

      Background

      Best-practice models delivering surgical care in the preoperative setting are unknown. In April 2018, we established a Same-Day Clinic (SDC) to increase the access and efficiency of general surgical care delivery.

      Methods

      This is a single-institution retrospective cohort study. We included patients who underwent elective laparoscopic cholecystectomy, inguinal or umbilical hernia repair. 112 patients were seen in the year prior to clinic creation; 84 were seen in the year following clinic creation.

      Results

      After clinic creation, the percentage of patients referred following an emergency department encounter decreased from 33.4 to 17.9%. Patients referred from primary care encounters increased from 28.6 to 44%. Patients who underwent pre-referral imaging decreased from 58.9% to 44%. The SDC cohort was seen 11 days sooner (40 vs. 29d).

      Conclusion

      The SDC increases access and decreases wait times to surgical treatment. It strengthens referral networks for traditionally underserved populations and reduces the burden of non-necessary preoperative imaging.

      Graphical abstract

      Keywords

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