F.TH’NG1, S.SWARUP1, D.NG1, T.K.LEE1, S.KAMSOL1
Khoo Teck Puat Hospital1
Prior to EDTU Dizziness protocol, A&E patients with ongoing dizziness had to be admitted to the wards to undergo MRI neuroimaging and/or vestibular rehabilitation therapy (VRT). This EDTU Dizziness protocol provides an alternate pathway for patients who may not require admission but need further assessment and observation for their dizziness prior to discharge.
The aims of this protocol are to: (1) Reduce admissions to inpatient wards by 50%, and (2) Reduce inpatient length of stay by 50%.
The EDTU Dizziness protocol was started in 2016, whereby EDTU patients would be able to undergo MRI neuroimaging and/or VRT within 24 hours. Exclusion criteria: Presence of new neurological deficit and/or other concomitant acute medical pathology needing further management.
Comparing A&E patients with dizziness in 2015 and in 2020, there was 82% reduction in inpatient ward admissions and 50% (1.83 days) reduction in average length of inpatient stay per patient. There was 54% ($919.00) reduction in individual patient’s bill size. None of the patients who re-presented within a month of discharge were diagnosed with stroke. There was an estimated bed day cost savings of $582,036 for 2020. These improvements in outcomes have been maintained yearly since the instatement of the protocol.
The EDTU Dizziness protocol for A&E patients with dizziness has met its set out aims. The protocol reduces inpatient admissions, patients’ bill size and length of inpatient stay. This protocol is safe and improves patients’ quality of care with earlier diagnosis and management.