Reduce Time for Diagnosis of Uncomplicated Cholecystitis


PDSA 1: Surgical registrars to choose appropriate timing of ultrasound scan referral to be consistent with the cholecystitis pathway.



To reduce the time from admission to booking theatre to ≤ 12 hours for Laparoscopic cholecystectomy for those patients with acute uncomplicated cholecystitis. This will help achieve the goal of 48 hours for time from admission to discharge for simple cholecystectomy.


The longest time in the patient journey is from admission to booking patient into theatre. The target is 12hrs and data from July 2016 - June 2017 shows this time averages 25hrs. Most of our patients (60%) do not have a diagnostic ultrasound performed within the target timeframe of 12 hours.


We focused on radiology constraints on the cholecystitis pathway between admission and diagnosis. Note: The radiology data still needs full validation by the Health Information Group.

Options to test:

  • 2 dedicated USS slots for general surgery in the morning Monday to Friday
  • USS referral choosing appropriate timing consistent with the cholecystitis pathway

Project Team

Team Member
  • Ian Ong, Surgical registrar
  • Hannah Collins, Surgical registrar
Project Sponsor
  • Richard Harman, Clinical Director of General surgery
Project Lead
  • Angie Hakiwai
Project Coach
  • Renee Kong

Next Steps

  • Validate the data
  • Ian and Hannah to complete a literature review of “Ultrasound scan by doctors at the bedside to diagnose cholecystitis” to see if this is feasible to implement locally.
  • Conduct PDSA cycle

Ian Ong

Surgical registrar

Hannah Collins

Surgical registrar

Richard Harman

Clinical Director of General surgery

Angie Hakiwai

Project Lead

Renee Kong

Project Coach
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