612 Consultant Review in the Emergency General Surgical Take: A Single-Centre Audit for Compliance to Royal College of Surgeon’s Guidelines

Abstract

Abstract Aim To assess if patients are reviewed within the timeframe suggested by the Royal College of Surgeons England (RCSE) and the association of guideline adherence with clinical outcomes in the emergency surgical take. Method We conducted a single-centre closed loop audit to assess the time taken for consultant review of the acute surgical patient. Clinical notes and electronic records were used to collect data on the acuity of the presenting complaint, time of review and plan by the consultant surgeon. Data was collected over an 8-week period before and after implementing changes in the form of educational sessions and email reminders regarding documentation. Post-implementation showed an improvement in record taking and, subsequently, increased compliance to RCSE guidelines. Results In the first and second cycle of this audit, 211 and 230 patients were seen, respectively. Before our intervention, of the 211 patients admitted to general surgery, 70% were reviewed within the recommended time, 10% had missing documentation and the remaining 20% were seen 1-2 hours outside the recommended window of time. Following intervention, 80% of the total surgical patients were reviewed within the recommended time and 5% had missing documentation. No worse outcomes were noted between any group of patients, outside the timeframe or otherwise. Conclusions Most patients reviewed on the general surgical take were seen within the recommended time. Below-standard documentation appeared to be the biggest cause of not meeting guidelines. Consistency regarding types of documentation, as well as teaching to highlight the standard of documentation required, may help rectify this.