PubMed · 10164628
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J Bagnal, G Burke, C Goff. 1997. Process analysis and re-engineering: a survival tool.. https://pubmed.ncbi.nlm.nih.gov/10164628/
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Pilot schemes for direct booking of hospital appointments have won support from the consultants involved. Skilled leadership has been crucial to managing changes that enable direct booking to be put into practice. The nursing role is central to the system, particularly in pre-operative assessment clinics. For direct booking to become widespread, management of all acute hospital resources will have to be reviewed.
The purpose of this study was to use population-based sources to estimate the frequency and characteristics of first inpatient hospital admission through an emergency department (ED) among 11,023 patients with diagnosed colorectal cancer between 1992 and 1996. Patients were identified from the population-based Connecticut Tumor Registry. Linkage with a statewide hospital discharge database (inpatient only) disclosed that 20% had a first hospital inpatient admission through an ED. Inpatient admission through an ED was statistically significantly associated with older age and race and was a statistically significant risk factor for distant stage at diagnosis. Studies are needed of the roles of patient delay and lack of screening in influencing ED presentation, especially in the elderly.