title: Improving the efficiency of the emergency general surgical service.
abstract: OBJECTIVE
  To improve the quality and efficiency of our emergency surgical service.
  
  
  METHODS
  Until 2007, the surgical on-call in our unit was run on a 'consultant of the day' model with triage in a 10-bed surgical receiving unit (SRU) before admission to the wards. The reduction in junior doctors' hours meant little continuity and delays in care.In July 2007, the SRU was expanded and a daily on-ward ultrasound session was established. The consultant rota was changed to a split-week model with twice-daily SRU ward rounds, allowing unstable patients regular senior assessment.
  
  
  RESULTS
  As a result of the change, our acute length of stay reduced from 4.4 to 3.8 days and our actual versus expected length of stay was the best figure country-wide.
  
  
  CONCLUSIONS
  Early consultant review and swift ultrasound assessment reduce admissions and patient stay. We have combined these factors in our emergency service and have delivered significant cost savings and improved care.
authors: The Royal Cornwall Hospital, Treliske, Truro, Cornwall, United Kingdom. catherinewestern@yahoo.co.uk
authors: Catherine E
authors: CE
authors: Western
authors: James William
authors: JW
authors: Faux
authors: Melanie
authors: M
authors: Feldman
mesh_terms: D003422:Critical Care / Q000706:statistics & numerical data*; D004059:Diffusion of Innovation; D017598:Efficiency, Organizational / Q000706:statistics & numerical data*; D004638:Emergency Treatment / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D017146:Models, Organizational; D010343:Patient Admission / Q000592:standards / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000592:standards / Q000706:statistics & numerical data*; D011872:Radiology Department, Hospital / Q000592:standards / Q000706:statistics & numerical data; D014218:Triage / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data*; D014463:Ultrasonography; D006113:United Kingdom