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SAGES 2026 Annual Meeting Emerging Technology Session
March 25-28, 2026 | Tampa, FL, USA
P794
IMPROVING ACCESS FOR UNINSURED PATIENTS WITH BILIARY DISEASE - A QUALITY INITIATIVE AT A SAFETY-NET HOSPITAL
Poster Presenter
Part of Topic
Quality Improvement / Health System Outcomes
Improving Access for Uninsured Patients with Biliary Disease – A Quality Improvement Initiative at a Safety-Net Hospital
Anne R Jeckovich, MD; Elene Clemens, MD, PhD; Coleman Miller, MD; Connor Purvis, MD; Tien Do, DO; Lindsey O'Leary, DO; Simran Singh, MD; Tamara Saunders, MD; McGovern Medical School at UTHealth Houston
Background
Biliary pathology is one of the most common digestive disorders. Increasing prevalence, especially among Hispanics1
1.2M ED visits and > 600,000 laparoscopic cholecystectomies (LC) annually in the US (2019). Frequent ED consult to general surgery
At LBJ Hospital: 1,132 LC performed; busiest ED in Houston (52.3% Hispanic, 44.3% uninsured)
Delays to OR disproportionately affect uninsured patients à higher risk for recurrent ED visits, admissions, and missed workdays. 1/3 adults in Harris County are uninsured
Problem Statement: Biliary disease is common – but lack of timely care worsens outcomes for vulnerable patients
Primary Aim: Reduce time from ED visit to elective cholecystectomy in our Outpatient Center
Methods
-Prospective pre-post quality improvement (QI) study
-Multidisciplinary stakeholder engagement
-Study Period: July 2024 – April 2025
-Pre and Post Intervention workflow
Stakeholders: LBJ Emergency Department (ED), LBJ Business Office, general surgery residents, Outpatient Surgery Coordinator
Results
-The mean time to ED visit to OC surgery decreased from 85 days to 30 days (p = 0.19)
Conclusion
-Implementation of an ED-drive QI initiative shortened time to cholecystectomy for uninsured patients by nearly two months
-Meaningful clinical impact
Future Work
-Continuation of fast track
-Scalability to other safety-net systems
References:
1.Unalp-Arida A, Ruhl CE. Burden of gallstone disease in the United States population: prepandemic rates and trends. World Journal of Gastrointestinal Surgery. 2024 Apr 27;16(4):1130–1148. doi:10.4240/wjgs.v16.i4.1130. PMID: 38690054.