title: Model-based evaluation of the Canberra Hospital Acute Care Surgical Unit : acute care surgery: a case of one size fits all?
abstract: OBJECTIVE
  Surgical services in Australia are under sustained and growing pressure. The global implementation of acute care surgery services has been shown to facilitate the timeliness of acute surgery. The question is: Do acute care surgical units fit major regional centers like ours? The current study coincides with the introduction of a Surgical Assessment and Planning Unit (SAPU) at the Canberra Hospital and compares patient outcomes before vs. after the introduction of the SAPU, using acute appendicitis as the model illness.
  
  
  METHODS
  We reviewed patients presenting to the Canberra Hospital Emergency Department with a preliminary diagnosis of acute appendicitis before vs. after the introduction of an acute care surgical unit.
  
  
  RESULTS
  The subjects were 150 patients, ranging in age from 16 to 97 years. The mean time from presentation at casualty to surgical review and the surgical review itself was reduced by 19 and 26 %, respectively (p < 0.05). Time to the operating table and the percentage of after-hours operations were reduced by 8 and 40 %, respectively. There was a significant reduction in the utilization of abdominal ultrasonography after the implementation of the SAPU.
  
  
  CONCLUSIONS
  The implementation of a SAPU has benefited the management of patients with acute surgical conditions. Ultimately, patient care is enhanced, with patients being reviewed, admitted, and treated earlier.
authors.affiliation: The Australian National University, Peter Baume Building 42, Canberra, ACT, 0200, Australia, feverinthecongo@gmail.com.
authors.forename: C J
authors.initials: CJ
authors.lastname: Beardsley
authors.forename: T
authors.initials: T
authors.lastname: Sandhu
authors.forename: S
authors.initials: S
authors.lastname: Gubicak
authors.forename: S V
authors.initials: SV
authors.lastname: Srikanth
authors.forename: K P
authors.initials: KP
authors.lastname: Galketiya
authors.forename: F
authors.initials: F
authors.lastname: Piscioneri
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001062:Appendectomy / Q000706:statistics & numerical data; D001064:Appendicitis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery*; D001315:Australia / Q000453:epidemiology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010346:Patient Care Management; D010347:Patient Care Planning; D012189:Retrospective Studies; D014463:Ultrasonography; D055815:Young Adult