Multidisciplinary Protocol Improves Management of GI Bleeding


Hollywood, Fla.—The findings of a new study suggest a standardized, multidisciplinary protocol helps improve the management of patients admitted to the hospital for acute gastrointestinal bleeding.

The protocol established patient ownership and facilitated communication among members of the health care team. After implementation of the protocol, patients had earlier interventions, required fewer packed red blood cell transfusions, had shorter hospitalizations and required fewer readmissions for acute GI bleeding.

“Doctors in several specialties noticed it was sometimes difficult to manage patients with acute GI bleeding because a lot of different services would be involved, and there often wasn’t a lot of communication among the different services,” said Tyler J. Loftus, MD, a surgical resident at the University of Florida, in Gainesville, and lead author of the study presented at the 2017 annual meeting of the Eastern Association for the Surgery of Trauma. Difficulties with communication were the impetus for developing the protocol.

To develop the protocol, a meeting was convened with representatives of different medical services: gastroenterology, interventional radiology, diagnostic radiology, critical care medicine and internal medicine. The attendees determined the best way to triage and manage a patient with acute GI bleeding, how to develop an agreed-upon treatment plan, and how to communicate that plan to their teams, patients and patients’ families.

Per the protocol, when a patient with acute GI bleeding is identified, the hospital transfer center coordinates a conference call between the gastroenterology, interventional radiology and acute care surgery teams. During the call, a treatment plan is developed that can be reassessed after procedural interventions or changes in patient status.

“The consensus plan is crucial because disagreement can occur regarding what tests should be ordered to diagnose the source of bleeding, and what procedures should be done to stop the bleeding,” Dr. Loftus said. This way, experts from different specialties can agree on the best way to diagnose and treat the patient.


From General Surgery News

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