SP3.2.2 Improving Acute Surgical Services and Establishing Same Day Emergency Care Clinic in a District General Hospital

Abstract

Abstract Introduction Surgical Same Day Emergency Care (SDEC) clinic service is a new challenging trend nationwide. We would like to share our experience establishing SDEC in a DGH setting. Our clinic runs two sessions daily Monday to Friday with capacity of 16 patients. The patients presented for; clinical follow-up post-discharge, radiological imaging and blood tests. All referrals are triaged by specialist nurses, seen by doctors of different grades - core surgical trainees and specialty doctors and supervised by the Consultant on-call. Methods Prospective ongoing audit carried out in SDEC monitoring the number of patients reviewed, diagnosis, investigations and outcome. We audited the documentation on the hospital's electronic system. Results In October 2021, 62 patients were reviewed, 97% had decisions made same day and only 3% required admission to SAU, 50% were allocated to a named consultant, 69% had blood tests, 53.2% had radiological investigations, 25% of patients were discharged with plans to follow up in elective clinics, and 1 patient was booked for elective operation. Our recommendations to improve quality of service were to allocate a dedicated staff nurse and healthcare assistant for more efficient workflow. Improving documentation of outcomes and allocating patients to named consultant for follow up. Conclusion Our model demonstrated successful service to provide semi-urgent care to surgical patients. SDEC has the capacity for more patients and subsequently will offload pressure from the emergency services provided by A&E and surgical admissions unit. This also makes a significant impact for on-call team to allow more focus on treatment of acute emergencies.