Acute Surgical Unit: The Consultant Experience

Stokes, Patrick Joe; Page, Dean

doi:10.4066/amj.2016.2664

Cited by 2 publications

(4 citation statements)

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“…[26][27][28][29] A survey of surgeon mentors also found that the ASU allowed more time for education and was beneficial for surgical training of juniors. 30 Several other studies also found that increased consultant presence increased registrar case load and satisfaction. 1,31,32 It also improved mentoring and teaching during challenging emergency cases.…”

Section: Egs Should Be Consultant Ledmentioning

confidence: 92%

“…Surgeons who are off-duty can plan their social or family commitments and acutely unwell patients can continue to have optimal care. 1,8,30,42 Promotion of safe working hours in surgery has become prevalent in developed countries. Simulator-based studies have shown that fatigued surgeons make more errors and operate more slowly compared to non-fatigued surgeons.…”

Section: Egs Should Be Consultant Ledmentioning

confidence: 99%

“…As a result, job satisfaction amongst surgeons being on call for EGS was low. Stokes et al, 30 in their questionnaire study of GSA members, found that 50% of the respondents reported improved job satisfaction and better work-life balance with the introduction of the ASU. Predictability of on call played a major part in the improved job satisfaction.…”

Section: Egs Should Be Consultant Ledmentioning

confidence: 99%

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General Surgeons Australia's 12‐point plan for emergency general surgery

Ang

Wong

Truskett

2019

ANZ Journal of Surgery

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In the last decade, emergency general surgery (EGS) in Australia and New Zealand has seen a transition from the traditional on‐call system to the acute surgical unit (ASU) model. The importance and growing demand for EGS has resulted in the implementation of the General Surgeons Australia's 12‐point plan for emergency surgery. Since its release, the 12‐point plan has been used as a benchmark of a well‐functioning ASU, both locally and abroad. This study aims to provide a descriptive review on the relevance of the 12‐point plan to the ASU model and review the current evidence to support this framework. The review concludes that the establishment of the ASU model has met the aims set out by the Royal Australasian College of Surgeons for EGS. The 12‐point plan is relevant and has good evidence to support its framework.

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Section: Egs Should Be Consultant Ledmentioning

confidence: 92%

Section: Egs Should Be Consultant Ledmentioning

confidence: 99%

Section: Egs Should Be Consultant Ledmentioning

confidence: 99%

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General Surgeons Australia's 12‐point plan for emergency general surgery

Ang

Wong

Truskett

2019

ANZ Journal of Surgery

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“…ASUs have been propagated throughout many tertiary Australian hospitals in the 21st century as a superior way to manage the emergency caseload with improved outcomes for clinicians and patients. [3][4][5][6] The first to be developed was at Prince of Wales Hospital in 2005. 7 Core principles of an ASU are: an onsite consultant-led service with a defined period of on-call time, a rigid handover process and separation of emergency and elective surgery lists.…”

Section: Introductionmentioning

confidence: 99%

Lessons learned from relocating an acute surgical unit to a new quaternary referral centre in Adelaide, South Australia: a tale of two hospitals

Barnett

Finlay

et al. 2019

ANZ Journal of Surgery

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Background On 4 September 2017, patient care was relocated from one quaternary hospital that was closing, to another proximate greenfield site in Adelaide, Australia, this becoming the new Royal Adelaide Hospital. There are currently no data to inform how best to transition hospitals. We conducted a 12‐week prospective study of admissions under our acute surgical unit to determine the impact on our key performance indicators. We detail our results and describe compensatory measures deployed around the move. Methods Using a standard proforma, data were collected on key performance indicators for acute surgical unit patients referred by the emergency department (ED). This was supplemented by data obtained from operative management software and coding data from medical records to build a database for analysis. Results Five hundred and eight patients were admitted during the study period. Significant delays were seen in times to surgical referral, surgical review and leaving the ED. Closely comparable was time spent in the surgical suite. Uptake of the Ambulatory Care Pathway fell by 67% and the Rapid Access Clinic by 46%. Overall mortality and patient length of stay were not affected. Conclusion We found the interface with ED was most affected. Staff encountered difficulties familiarizing with a new environment and an anecdotally high number of ED presentations. Delays to referral and surgical review resulted in extended patient stay in ED. Once in theatre, care was comparable pre‐ and post‐transition. This was likely from early identification of patients requiring an emergency operation, close consultant surgeon involvement and robust working relationships between surgeons, anaesthetists and nurses.

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Acute Surgical Unit: The Consultant Experience

Cited by 2 publications

References 0 publications

General Surgeons Australia's 12‐point plan for emergency general surgery

General Surgeons Australia's 12‐point plan for emergency general surgery

Lessons learned from relocating an acute surgical unit to a new quaternary referral centre in Adelaide, South Australia: a tale of two hospitals

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