title: Implementation of an acute surgical admission ward.
abstract: BACKGROUND
  The aim of the study was to assess the impact of an acute surgical admission ward on admission and discharge processes.
  
  
  METHODS
  This prospective cohort study was conducted in a university tertiary referral centre. All acute surgical patients were clustered in the acute surgical unit (ASU) in February and March 2012, and discharged or transferred to specialized departments within 48 h. The primary outcome was length of hospital stay (LOS). Secondary outcomes were impact on emergency department waiting times, discharge home within 48 h, incorrect ward admissions, readmissions and mortality. Outcomes of the study group were compared with those of a historical reference group admitted during the same interval the year before.
  
  
  RESULTS
  Some 249 patients were admitted to the ASU during the study interval. The reference group consisted of 211 patients. The total LOS decreased significantly from a median of 4·0 to 2·0 days (P = 0·004). The percentage of patients who were discharged within 48 h increased from 30·3 to 43·4 per cent (P = 0·004). The rate of incorrect ward admission decreased from 9·5 to 0 per cent. Emergency department waiting time, readmission rate and 30-day mortality did not change.
  
  
  CONCLUSIONS
  Introduction of an acute surgical unit-shortened length of hospital stay without comprising readmission and mortality rates.
authors.affiliation: Departments of Surgery, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: C F H
authors.initials: CF
authors.lastname: Eijsvoogel
authors.forename: R W
authors.initials: RW
authors.lastname: Peters
authors.forename: A J
authors.initials: AJ
authors.lastname: Budding
authors.forename: D T
authors.initials: DT
authors.lastname: Ubbink
authors.forename: H
authors.initials: H
authors.lastname: Vermeulen
authors.forename: N W L
authors.initials: NW
authors.lastname: Schep
mesh_terms: D000208:Acute Disease / Q000628:therapy*; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D010362:Patients' Rooms / Q000706:statistics & numerical data*; D011446:Prospective Studies; D013503:Surgery Department, Hospital / Q000706:statistics & numerical data*; D061665:Time-to-Treatment; D014850:Waiting Lists