The surgical assessment unit--effective strategy for improvement of the emergency surgical pathway?
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.
Mohamed
M S
MS
Directorate of Surgery & Anaesthetics, Medway Maritime Hospital, Windmill Road, Gillingham ME7 5NY, UK.
Mufti
G R
GR
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019091:Critical Pathways / Q000458:organization & administration / Q000592:standards*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D010343:Patient Admission; D005791:Patient Care / Q000592:standards*; D011446:Prospective Studies; D012017:Referral and Consultation; D013503:Surgery Department, Hospital / Q000458:organization & administration*