title: Acute surgical unit: the Australasian experience.
abstract: BACKGROUND
  The acute surgical unit (ASU) model of care is a new paradigm shift in the provision of emergency surgery. Clinical and non-clinical outcomes have been described after the introduction of the ASU model in Australia and New Zealand. This paper reviews and analyses the current published literature and methods of implementation of contemporary ASU models.
  
  
  METHODS
  We conducted a comprehensive database search to identify all relevant published papers pertaining to the ASU. Included papers compared ASU models to emergency surgery's traditional model of care. Relevant clinical and non-clinical end points were extracted for analysis.
  
  
  RESULTS
  Seven papers and two abstracts published data assessing clinical and non-clinical end points within the ASU. Four out of six studies reported a reduction in hospital length of stay. Two out of three studies showed reduction in mean time to emergency department review and two out of four studies reported a reduction in time to surgery. Additionally, four out of five studies showed a reduction in after hours operating with an ASU model.
  
  
  CONCLUSIONS
  Trends in clinical outcomes are seen including reduced length of stay, time to emergency department assessment and surgery, supplemented by non-clinical outcomes including reduced after hours operating and the potential for increased training opportunities. The published data presents certain weaknesses and further information is required to appreciate the applicability of certain aspects of the ASU model to smaller centres.
authors.affiliation: Department of Surgery, St Vincent's Hospital, Melbourne, Victoria, Australia.
authors.forename: Dean E
authors.initials: DE
authors.lastname: Page
authors.forename: Dilshad
authors.initials: D
authors.lastname: Dooreemeah
authors.forename: Dhan
authors.initials: D
authors.lastname: Thiruchelvam
mesh_terms: D039602:After-Hours Care; D001315:Australia; D003695:Delivery of Health Care / Q000458:organization & administration*; D004630:Emergencies; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D013502:General Surgery / Q000458:organization & administration*; D006801:Humans; D007902:Length of Stay; D017146:Models, Organizational; D009520:New Zealand; D010043:Outcome and Process Assessment, Health Care; D013503:Surgery Department, Hospital / Q000458:organization & administration*; D013514:Surgical Procedures, Operative
keywords: ASU; acute surgical unit; emergency general surgical unit; emergency surgery; general surgery