Skip to main content

Main menu

  • Home
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • COVID-19 Articles
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
    • Open access
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2022
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN

User menu

Search

  • Advanced search
CMAJ
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN
CMAJ

Advanced Search

  • Home
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • COVID-19 Articles
  • Authors
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
    • Open access
  • CMA Members
    • Overview for members
    • Earn CPD Credits
    • Print copies of CMAJ
  • Subscribers
    • General information
    • View prices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2022
  • Visit CMAJ on Facebook
  • Follow CMAJ on Twitter
  • Follow CMAJ on Pinterest
  • Follow CMAJ on Youtube
  • Follow CMAJ on Instagram
Letters

Urgent care access: finding solutions that match causation

Paul E. Beaule, Sudhir Nagpal, Fady Balaa and Sudhir Sundaresan
CMAJ January 15, 2018 190 (2) E56; DOI: https://doi.org/10.1503/cmaj.733536
Paul E. Beaule
Professor of Surgery, University of Ottawa, Ottawa, Ont.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Sudhir Nagpal
Division Head, Department of Surgery, University of Ottawa, Ottawa, Ont.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Fady Balaa
Head, Division of General Surgery, University of Ottawa, Ottawa, Ont.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Sudhir Sundaresan
Professor of Surgery and Division Head of Thoracic Surgery, The Ottawa Hospital, Ottawa, Ont.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Responses
  • Metrics
  • PDF
Loading

The recent research article by McIsaac and colleagues1 has generated some important discussions and reflections within our perioperative and quality teams, some of which we would like to share with the readership.

First and foremost, although press coverage may vary with regard to highlighting various parts of the article, we want to emphasize the primary message: the importance of timely access to urgent care, as well as the challenges of providing that care in the face of constrained resources. As clinicians providing that care, it is our responsibility to remain engaged at all levels to look for credible and sustainable solutions.

This brings us to some of the limitations of the findings of the study. As stated in the study, data were collected from 2012 to 2014, during implementation of a new system for categorizing urgent surgeries. Hence, one has to ask: Was there a “learning curve” in the implementation and execution of this system, which inevitably could have affected access? Could this have influenced the incidence of delays over various time periods of the study period? Because most cases were of the “E” category (i.e., wait time standard of less than 24 hours), does the impact of a delay have the same importance (i.e., mortality and/or morbidity) for the various categories of urgent booking? Finally, do we fully understand which measures could have the greatest impact on minimizing mortality/morbidity as a function of cause of delay? In other words, if, for example, the incidence of “bumping of cases” were decreased by half, would that have the desired effect (i.e., decreasing mortality/morbidity)? Could this be done without increasing resources but by improving communication between the various stakeholders?

In conclusion, this study has generated important discussions with the various stakeholders within our institution, and we encourage other institutions to have these conversations, as we constantly strive toward more patient-centred solutions.

Footnotes

  • Competing interests: None declared.

Reference

  1. ↵
    1. McIsaac DI,
    2. Abdulla K,
    3. Yang H,
    4. et al
    . Association of delay of urgent or emergency surgery with mortality and use of health care resources: a propensity score–matched observational cohort study. CMAJ 2017;189:E905–12.
    OpenUrlAbstract/FREE Full Text
PreviousNext
Back to top

In this issue

Canadian Medical Association Journal: 190 (2)
CMAJ
Vol. 190, Issue 2
15 Jan 2018
  • Table of Contents
  • Index by author

Article tools

Respond to this article
Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Urgent care access: finding solutions that match causation
(Your Name) has sent you a message from CMAJ
(Your Name) thought you would like to see the CMAJ web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Urgent care access: finding solutions that match causation
Paul E. Beaule, Sudhir Nagpal, Fady Balaa, Sudhir Sundaresan
CMAJ Jan 2018, 190 (2) E56; DOI: 10.1503/cmaj.733536

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
Urgent care access: finding solutions that match causation
Paul E. Beaule, Sudhir Nagpal, Fady Balaa, Sudhir Sundaresan
CMAJ Jan 2018, 190 (2) E56; DOI: 10.1503/cmaj.733536
Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like

Jump to section

  • Article
    • Footnotes
    • Reference
  • Responses
  • Metrics
  • PDF

Related Articles

  • Association of delay of urgent or emergency surgery with mortality and use of health care resources: a propensity score–matched observational cohort study
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Succinylcholine, malignant hyperthermia and rhabdomyolysis
  • Study authors don’t consider waning SARS-CoV-2 immunity after vaccination in their model
  • The authors respond to criticisms of their model parameters
Show more Letters

Similar Articles

 

View Latest Classified Ads

Content

  • Current issue
  • Past issues
  • Collections
  • Sections
  • Blog
  • Podcasts
  • Alerts
  • RSS
  • Early releases

Information for

  • Advertisers
  • Authors
  • Reviewers
  • CMA Members
  • Media
  • Reprint requests
  • Subscribers

About

  • General Information
  • Journal staff
  • Editorial Board
  • Advisory Panels
  • Governance Council
  • Journal Oversight
  • Careers
  • Contact
  • Copyright and Permissions
  • Accessibiity
  • CMA Civility Standards
CMAJ Group

Copyright 2022, CMA Impact Inc. or its licensors. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

To receive any of these resources in an accessible format, please contact us at CMAJ Group, 500-1410 Blair Towers Place, Ottawa ON, K1J 9B9; p: 1-888-855-2555; e: cmajgroup@cmaj.ca

Powered by HighWire