title: Role of an acute assessment and review area for general surgical patients.
abstract: 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.
authors.affiliation: Department of General Surgery, Christchurch Hospital, Christchurch, New Zealand.
authors.forename: Ellen
authors.initials: E
authors.lastname: Perry
authors.forename: Stuart
authors.initials: S
authors.lastname: Mackintosh
authors.forename: Saxon
authors.initials: S
authors.lastname: Connor
mesh_terms: 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