A&E/EDTU Managing Patients with Menorrhagia
Care Process & Redesign
Yishun Health One Improvement Festival
National Healthcare Group
8 April 2025
1. Ward admission rate of A&E patients needing management of menorrhagia with anaemia by 50%. The implementation of the EDTU Menorrhagia pathway ensures that patients continue to receive care from the A&E team, facilitating the.
Year Submitted: 2025
Published Date: 08 April 2025
Tags: Quality Improvement, Workflow Redesign, Cost Saving, Care Process ＆ Redesign, Value Based Care, Length Of Stay, Productivity
About this Content
Aims
1. Ward admission rate of A&E patients needing management of menorrhagia with anaemia by 50%.
2. The length of inpatient stay by 50%.
Background
Prior to the implementation of the EDTU Menorrhagia pathway, patients presenting to A&E with menorrhagia and associated anaemia were required to be admitted to the wards for further monitoring and treatment. This process resulted in disjointed care and prolonged wait times for patients.
Methods
The EDTU Menorrhagia pathway was implemented on 1st March 2024 for patients presenting with heavy menstrual bleeding with anaemia. Interventions included blood transfusion or intravenous iron injection, oral mefenamic acid, oral tranexamic acid or intramuscular progesterone, and discharge planning with follow-up referrals.
Results
87% Reduction in Ward Admission. 38 patients were admitted to EDTU under the EDTU Menorrhagia Protocol during the pilot phase. 33 patients were discharged home within 24 hours of EDTU admission (92%) with no A&E readmission within a month for related complications. 90% Reduction in Average Length of Inpatient Stay. Bed day savings = 231 bed days. Bed day cost savings = $462,000.
Conclusion
The implementation of the EDTU Menorrhagia pathway ensures that patients continue to receive care from the A&E team, facilitating the development of a quicker and more consistent management plan in accordance with established protocols. This streamlined approach enhances the efficiency of clinical teams, generates cost savings, and elevates the quality of care provided to this patient group.
Lessons Learnt
Regular audits were conducted to ensure compliance and identify areas for improvement. Regular review and feedback from staff helped smoothen the execution of the protocol.
Additional Information
Inclusion criteria: >16 years old, not pregnant. Exclusion criteria: Hb level less than 5g/dL, haemodynamic instability, other causes of anemia, significant co-morbidities.
Keywords
Menorrhagia, Anaemia, Emergency, Protocol, Cost Savings
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National Healthcare Group |
Organization(s) Involved | Khoo Teck Puat Hospital |
Platform(s) | Yishun Health One Improvement Festival |
Healthcare Professional Group(s) | Nursing |
Applicable Specialty or Discipline | Emergency Medicine |
Project Lead(s) | Th’ng F, Swarup S |
Project Member(s) | Rachel Yek |
Connect with this contributor!
KTPH & YCH Innovation & Improvement (I&I) Office - i-i@ktph.com.sg
Project Attachment
767_KTPH_OIF 2025_EDTU Managing Patients with Menorrhagia.pdf