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Optimisation of hyperemesis gravidarum management through an emergency department setting
  1. Graham Skalley1,
  2. John Denny2,
  3. Eve Allen3,
  4. Shwetha Rao1
  1. 1Emergency Department, Princess Royal University Hospital, Orpington, Kent, UK
  2. 2Department of General Medicine, Princess Royal University Hospital, Orpington, Kent, UK
  3. 3Obstetrics and Gynaecology Department, Princess Royal University Hospital, Orpington, Kent, UK
  1. Correspondence to Dr Shwetha Rao; k1645513{at}kcl.ac.uk

Abstract

Hyperemesis gravidarum is a common condition characterised by severe nausea and vomiting. The referral process from the emergency department (ED) to obstetrics and gynaecology (O&G) can lead to treatment delays before the gynaecology team review the patient, resulting in unnecessary prolonged inpatient stays in O&G. This quality improvement project created a clinical pathway which optimised care of patients presenting with hyperemesis gravidarum in the ED at the Princess Royal University Hospital using a treatment protocol. Two audits were carried out to assess improvements in patient care and reduction in admissions to O&G. Overall, admissions to O&G were reduced by 68.7% (cycle 1) and 70.5% (cycle 2) compared with admission rates before the proforma, saving the trust an estimated £265 700 and 235 bed days over a year.

  • emergency department
  • women’s health
  • pdsa
  • clinical practice guidelines
  • quality measurement

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors SR and EA contributed to the conception or design of the work, critical revision of the article and final approval of the version to be published. GS and JD contributed to data collection, data analysis, interpretation and drafting the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.