title: Effect of handover on the outcomes of small bowel obstruction in an acute care surgery model.
abstract: BACKGROUND
  An acute care surgery (ACS) model was introduced to manage emergency surgical presentations efficiently. The aim of this study was to evaluate the impact of patient handover in an ACS model on the outcomes of adhesive small bowel obstruction (SBO).
  
  
  METHODS
  A retrospective study was performed on patients who were admitted with adhesive SBO at Prince of Wales Hospital. The cohort consisted of all patients treated by the ACS team from its introduction in September 2005 to February 2011. Patients in the ACS cohort were divided into two groups: those whose care was handed over to another surgeon and those whose care was not. These groups of patients were compared with a random sample of 50 patients in the pre-ACS period.
  
  
  RESULTS
  In the ACS period, there was no significant difference in complication rates or length of hospital stay in those who were not handed over and those who were. A significantly higher proportion of operations took place during the day for the group who had been handed over (72.7% versus 36.7%; P = 0.005). There were no significant differences in complication rates or length of hospital stay in the pre-ACS and ACS period.
  
  
  CONCLUSIONS
  Management under an ACS team does not increase adverse outcomes for adhesive SBO. Patients can be safely handed over within an ACS framework. Other members of the ACS team may help facilitate continuity of care.
authors.affiliation: Department of Surgery, Prince of Wales Hospital, Sydney, New South Wales, Australia; University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Ivy
authors.initials: I
authors.lastname: Lien
authors.forename: Shing W
authors.initials: SW
authors.lastname: Wong
authors.forename: Phillip
authors.initials: P
authors.lastname: Malouf
authors.forename: Philip G
authors.initials: PG
authors.lastname: Truskett
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D015331:Cohort Studies; D004638:Emergency Treatment / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis* / Q000601:surgery*; D007421:Intestine, Small / Q000473:pathology / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D017146:Models, Organizational; D062209:Patient Handoff / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome; D055815:Young Adult