A laparoscopic cholecystectomy quality improvement project was therefore initiated. Through retrospective analysis of the medical notes, hospital episode statistics coding was analysed for accuracy and compared to actual clinical practice. A pathway encompassing current guidelines was disseminated via education, trust induction and a protocol including increased USS provision 4 weekday and 2 weekend patients per day , theatre 1 session per week and senior clinician led coding of discharge and theatre paperwork.
The service was then re-evaluated. Areas for improvement were therefore targeted as referral for surgery, prompt USS including out of hours , increased theatre capacity and more accurate coding for hospital episode statistics. No patients on the elective waiting list had an emergency admission. Our 'Best in Study' award from CholeQuic-ER was confirmed with the hospital episode statistics, which have improved accuracy following senior input into coding.
Conclusion s : Results confirm significant quality improvement for patients presenting with acute biliary pathology. These interventions could be disseminated to gain better outcomes nationally.
Background: Increasing evidence suggests a role for the vermiform appendix in onset and relapse of ulcerative colitis UC. Consequently, appendectomy is increasingly being seen as a potential alternative treatment. As a recent study suggests that patients with histological appendiceal inflammation are most likely to respond, pre-operative identification of ulcerative appendicitis could be beneficial.
Intestinal ultrasound IUS is increasingly utilized in the diagnosis and follow-up of patients with UC. The objective of this study was to characterize the appendix by IUS in UC patients with active and quiescent disease and healthy controls. During IUS, the appendix was identified by a bowel structure with cecal origin and a blind ending tip. An increased diameter occurred irrespective of disease extent A higher proportion of UC patients had incompressibility when compared to healthy controls Fig.
