title: Results of the centralisation of adult emergency oral and maxillofacial surgical services at the University Hospital, Birmingham.
abstract: In 2001, the oral and maxillofacial surgical (OMFS) services for adults in Birmingham were centralised at the Selly Oak site of the University Hospital and the OMFS department was given access to the emergency operating theatre every day. We examined the effects of this on the emergency workload during the 6 months after centralisation and compared it with the emergency workload at the University Hospital during the 6 months before centralisation. The number of adult patients who attended the University Hospital as emergencies increased from 242 in the 6 months before centralisation to 545 in the subsequent 6 months (an increase of 127%). Of the latter 164 (30%) were admitted and operated on, 138 (84%) within 24h of admission. Despite the large increase in the number of patients, 102 (74%) were operated on during normal working hours. After centralisation, all operations were done on multidisciplinary emergency lists compared with only 55% before centralisation. Centralisation did not reduce the access of patients to the emergency service and conformed with the guidelines of the National Confidential Enquiry into Perioperative Deaths (NCEPOD).
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Hospital of North Staffordshire, Hartshill, Stoke on Trent, UK. gjjames@aol.com
authors.forename: G J
authors.initials: GJ
authors.lastname: James
authors.forename: A J
authors.initials: AJ
authors.lastname: Gibbons
authors.forename: D
authors.initials: D
authors.lastname: Srinivasan
authors.forename: M Stephen
authors.initials: MS
authors.lastname: Dover
mesh_terms: D000328:Adult; D002497:Centralized Hospital Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D003796:Dental Service, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data; D004739:England; D006785:Hospitals, University / Q000458:organization & administration*; D006801:Humans; D013503:Surgery Department, Hospital / Q000458:organization & administration / Q000706:statistics & numerical data; D013515:Surgery, Oral / Q000193:education / Q000458:organization & administration*; D014600:Utilization Review; D016526:Workload