The management of emergency surgical patients in a surgical assessment unit

Ph, Rowe; Lawrence, WT; Fellows, Elaine P.

doi:10.1308/147363503322310520

Cited by 5 publications

(5 citation statements)

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“…9,10 The increase in number of admission between 2004 and 2005 in our study period has been small (3.3%). The major impact of the new appointment on the delivery of service has been on: (i) the increase of day-time operating (57% to 74%); (ii) shorter hospital stay; and (iii) ensured continuity of care.…”

Section: Impact On Servicementioning

confidence: 67%

The Dedicated Emergency Surgeon: Towards Consultant-Based Acute Surgical Admissions

Sorelli

El-Masry

et al. 2008

annals

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INTRODUCTIONThe management of an efficient acute surgical service with conflicting pressures of managing elective and emergency work, compounded by waiting list targets and the maximum 4-h wait for patients in accident and emergency poses a significant challenge. We assess the impact of appointing a dedicated emergency surgeon on the delivery of our emergency surgery service. There was a significant increase in daytime operating from 57% in 2004 to 74% in 2005 (P < 0.001) and a significant increase in consultant-supervised operations from 14% to 52% (P < 0.001), with a consequent fall in out-of-hours operating (43% to 26%; P < 0.001). In addition, there was a significant increase in early (within 48 h) discharges from 41% to 53% (P < 0.001). The salary of the new appointment is more than offset by the quantifiable savings of approximately £90,000 per annum based on the increased proportion of earlier discharges alone as well as the improved quality of care provided.CONCLUSIONS The appointment of a dedicated emergency surgery consultant has resulted in an increase in day-time consultantsupervised operating, shorter hospital stay for emergency admissions, improved training for surgical trainees, as well as providing potential financial savings for the trust.

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Section: Impact On Servicementioning

confidence: 67%

The Dedicated Emergency Surgeon: Towards Consultant-Based Acute Surgical Admissions

Sorelli

El-Masry

et al. 2008

annals

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“…7 However, there is only one published report on a surgical assessment unit (SAU). 8 When considering the possible merits of an SAU at our hospital we found, in a three-month audit, that the ratio of emergency to elective surgical admissions within general surgery and urology was 1.5 to 1-confirming the impression that emergencies form a major part of the workload in these two specialties. Yet these patients are customarily tagged on to the elective component of the workload and commonly encounter delays.…”

Section: Introductionmentioning

confidence: 73%

The Surgical Assessment Unit—Effective Strategy for Improvement of the Emergency Surgical Pathway?

Mohamed

Mufti

2005

J R Soc Med

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A special unit was set up in an associate teaching hospital to provide a fast-track route for the assessment of acute adult surgical and urological referrals. During an audit period of eight weeks, this surgical assessment unit had 550 referrals, of which 196 (36%) came via the accident and emergency (A&E) department; the other 354 came directly from general practitioners or other hospital departments. Mondays, Tuesdays and Fridays were the busiest days of the week; 57% of all patients arrived between 8 am and 5 pm. 68% were seen by a doctor within 1 hour of their arrival. 68% were either discharged or admitted to the main surgical wards within 4 hours. The study showed that, over the course of a year, the surgical assessment unit might divert some 2301 patients away from the A&E department. To achieve this total it would need to be open and appropriately staffed 24 hours a day. Such a unit offers a strategy for limiting the A&E workload and streamlining the assessment of patients with surgical and urological emergencies.

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“…In order to increase availability of daytime operative availability and meet caseload demands, hospitals can create capacity for emergency cases on elective lists, use evening and weekend theatre sessions for semi-urgent cases, and physically separate emergency and elective operating teams. [1][2][3][4][5][6]9,20 However, it is recognised that it is not always possible to delay a procedure until the next morning.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6] Acute surgical care models and emergency general surgery (EGS) units have been developed with the aim of increasing consultant-led patient care, dedicated in-hours emergency theatre lists and improved surgeon satisfaction. 1,3,[6][7][8][9] These have led to reductions in time to definite operative management, as measured by benchmark emergency procedures such as appendicectomy, cholecystectomy and hip joint replacements for femoral fractures.…”

Section: Introductionmentioning

confidence: 99%

Waiting for definitive care: An analysis of elapsed time from decision to surgery or transfer in a rural centre

Dobson¹,

Ranasinghe²,

Hong³

et al. 2015

Aust J Rural Health

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The management of emergency surgical patients in a surgical assessment unit

Cited by 5 publications

References 0 publications

The Dedicated Emergency Surgeon: Towards Consultant-Based Acute Surgical Admissions

The Dedicated Emergency Surgeon: Towards Consultant-Based Acute Surgical Admissions

The Surgical Assessment Unit—Effective Strategy for Improvement of the Emergency Surgical Pathway?

Waiting for definitive care: An analysis of elapsed time from decision to surgery or transfer in a rural centre

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