Role of an acute assessment and review area for general surgical patients.
BACKGROUND
Increasing demand for acute surgical services is one of the major challenges facing modern health systems. The aim of this study was to assess the impact of implementing a dedicated surgical assessment and review area (SARA) on patient flow for acute general surgical patients at a major teaching hospital in New Zealand.


METHODS
A specific area within inpatient surgical beds was redeveloped and staffed by a dedicated surgical team. Prospective data pertaining to patient flow and outcomes were collected (10-month period) and compared with historical controls (preceding 14 months prior to implementation).


RESULTS
During the 24-month period 9182 acute general surgical patients were admitted (3836 [41.1%] post implementation of SARA). Subsequent to the introduction of SARA, 865 (22.5%) patients were referred directly from their general practitioner. Length of stay was reduced in all patients from 2.58 to 2.04 days (P < 0.001) and in those who did not require surgery from 2.56 to 1.96 days (P < 0.001). However, the number of days in which the department of surgery had outlying patients increased significantly from 76.7% to 86.3%, P < 0.001.


CONCLUSIONS
The introduction of a dedicated SARA significantly reduced hospital stay and improved efficiencies of the emergency department.
Perry
Ellen
E
Department of General Surgery, Christchurch Hospital, Christchurch, New Zealand.
Mackintosh
Stuart
S
Connor
Saxon
S
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital / Q000458:organization & administration; D005260:Female; D013502:General Surgery / Q000458:organization & administration*; D006757:Hospital Units / Q000458:organization & administration*; D006784:Hospitals, Teaching / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D005791:Patient Care; D011446:Prospective Studies; D055815:Young Adult