EP.FRI.271 The impact of Surgical Assessment Unit on emergency and ambulatory surgical care in a district general hospital

Abstract

Abstract Aims There has been a paradigm shift in the delivery of emergency and ambulatory surgical care necessitated by paucity of beds, improved expedited diagnostics and delayed transit in Emergency departments. The objective of a surgical assessment unit (SAU) is to reduce the number of semi-urgent admissions, provide direct access to urgent surgical admissions bypassing the ED, expeditious assessment by senior clinicians and to reduce the number of OPD follow up. In our setting, the SAU came into existence on all 5 working days at 12-hour daily schedule and its impact was evaluated retrospectively. Methods Prospectively maintained data base over a 2-month period was examined. Pre and post SAU figures were compared to judge any quantitative improvement in surgical services. Results During the audit period of 2 months there were 156 emergency patients and 190 ward attenders for follow up care. Majority of these patients were assessed within 4 hours and discharged or ambulated. Numbers being admitted overnight purely to facilitate investigations showed a decrease of 44.6% post SAU establishment. There was a reduction in post discharge outpatients appointments when compared to a similar time period pre SAU (14% difference). Conclusion The SAU, although initially conceived and designed purely to cope with increased admissions and to minimise breaching of emergency department targets, has shown quantitative and qualitative improvement in emergency and ambulatory surgical care delivery.