Decreasing length of stay with emergency ultrasound examination of the gallbladder.

Abstract

To determine whether patients who received emergency screening ultrasound examinations (ESUEs) of the gallbladder by emergency physicians (EPs) have a shorter ED length of stay (LOS) than do those receiving ultrasound studies from radiology. A retrospective chart review from July 1995 to August 1998 identified 1,242 patients who received gallbladder ultrasound examinations. Seven hundred fifty-three patients received ESUEs by EPs of varying levels of ultrasound experience. Four hundred eighty-nine patients received gallbladder ultrasound examinations from radiology, and were not scanned by EPs. The LOSs of the two groups were compared. Significance was evaluated using a two-tailed t-test. When patients received an ESUE by an EP, the median LOS was 7% (22 min) less than that for those who received an ultrasound examination by radiology (p = 0.017; 95% CI = 4 min to 41 min). When evaluated by disposition, patients discharged home and scanned by EPs had their median LOSs shortened by 11% or 32 minutes (p = 0.02; 95% CI = 5 min to 55 min). When evaluated by time of day, patients who presented after hours (6 PM-6 AM) and were scanned by EPs spent 15% (52 min) less time in the ED (p = 0.0002; 95% CI = 26 min to 89 min). Those who were seen after hours and discharged home had their LOSs shortened by 20% (1 hr, 13 min, p = 0.001; 95% CI = 28 min to 1 hr, 56 min). In a teaching hospital with a residency program, ESUEs decrease ED LOS for these patients. The difference was most apparent for patients presenting after hours.