SHM Converge Scientific Abstract ePoster Gallery-Impact of an Outpatient Paracentesis Clinic on Ed Utilization at a Safety Net Hospital

Pdf Summary

This study evaluated whether creating an outpatient fluid aspiration/paracentesis clinic (FLASP) at LACUSC Hospital could reduce emergency department (ED) overuse by patients with refractory ascites from decompensated cirrhosis. Refractory ascites is a common complication of cirrhosis and is often treated either with TIPS or repeated large-volume paracentesis (LVP). At safety-net hospitals, patients frequently come to the ED for this non-urgent procedure, creating strain on ED resources.<br /><br />The FLASP clinic was launched on February 11, 2021 and staffed by a hospitalist, nurse, and scheduling clerk. Investigators performed a retrospective review of all ED patients who underwent paracentesis between December 1, 2020 and July 31, 2021, comparing outcomes before and after the clinic opened. Patients were assessed by age, gender, and whether they were admitted or discharged after the procedure.<br /><br />The results showed that the average number of daily ED presentations for paracentesis decreased from 1.70 cases per day before the clinic to 1.05 cases per day after the clinic was established, a statistically significant reduction (p < 0.001). There were no significant differences between the pre- and post-clinic groups in age or gender.<br /><br />The authors conclude that a dedicated outpatient paracentesis clinic can reduce ED utilization and potentially improve ED flow, especially in resource-limited safety-net settings where radiology-based outpatient paracentesis may not be feasible. They suggest expanding the clinic model to include thoracentesis and lumbar punctures in the future, and recommend larger multicenter studies with propensity score matching to confirm these findings.

Asset Subtitle

Jennifer Koh

Meta Tag

Author List Annasha Vyas, Irene Chang, Jennifer Koh, Shadi Dowlatshahi, Shane Shahrestani, Varun Angajala

Category Innovations

Concept Refractory Ascites

Concept Decompensated Cirrhosis

Concept Emergency department utilization

Concept Outpatient Paracentesis

Concept Paracentesis

Distinguished Non-Finalist

Presenter Organization LAC-USC Hospital

Presenting Author Jennifer Koh

Track Quality Improvement

Keywords

outpatient paracentesis clinic

refractory ascites

decompensated cirrhosis

emergency department overuse

large-volume paracentesis

safety-net hospital

fluid aspiration clinic

ED utilization reduction

TIPS

hospitalist-led clinic

Refractory Ascites

Decompensated Cirrhosis

Emergency department utilization

Outpatient Paracentesis

Paracentesis