Conclusion and Recommendations
The ‘Pack and Home’ criteria successfully identifies patients who are
suited to outpatient management pathway. Three patients on the ‘Pack and
Home’ pathway re-presented back to hospital within 48 hours of which
only one re-bled and therefore deemed as unsuccessful management. This
pathway could reduce inpatient admissions, have positive financial
implications, and ultimately impact bed availability for surgical
patients.
Therefore we recommend the following:
- Ensure clinicians are fully aware of ‘pack and home’ criteria.
- Continue outpatient management
pathway as routine (in non-pandemic times).
- Patients should ideally be seen either the following day or day two of
pack insertion (day 3+ not optimal).
- We should ensure patients on the outpatient pathway are adequately
counselled about what to do if re-bleed occurs and safety net.