83 Quality Improvement Project on the Adherence to Hot Gallbladder Pathway Clinical Guidelines: An Improvement of the Hot Gallbladder Referral Pathway

Abstract Aim The quality improvement project’s main aim is to improve utilization of the Hot-Gallbladder(HGB) list. Although the guidelines are clear, a large number of referrals did not meet the criteria and were deemed inappropriate. We designed a self-explanatory proforma and added educational posters/aids that helped increase orientation and clarified the process and criteria. Method A set period of referrals was examined and audited and compared to the data collected post introduction of the proforma. The first audit cycle looked at patients referred for emergency laparoscopic cholecystectomy during April-May 2023 which determined the need for interventions to improve utilization of the HGB list and adherence to guidelines. A well designed self-explanatory pro-forma was introduced along with informative posters. A second audit cycle was done during the months of June-July 2023 showing significant improvement. Results April-May 2023: 38 referrals, 4/34 accepted (10.5% successful). June-July 2023: 24 referrals, 7/24 accepted (29.2% successful). Average stay in hospital: April-May 2023: 6.45 days, June-July 2023: 3.88 days. Conclusions The introduction of the well-designed self-explanatory proforma has improved the quality of referrals and raised the awareness of the presence of the pathway. This has in turn improved utilization of HGB lists, decreased the load on elective lists and improved outcomes.