SP9.4 Improving time to initial consultant review for emergency general surgery admissions at a major trauma centre

Abstract

Abstract NHS England’s Seven Day Services Clinical Standards and NCEPOD Guidance recommend 100% of emergency admissions to hospital should receive an initial consultant review within 14-hours of hospital admission. An audit of time for initial consultant review for emergency general surgery (EGS) admissions at a Major Trauma Centre revealed only 75% of patients were reviewed by a consultant surgeon within the 14-hour target, with longest time to review 20 hours and 56 minutes. Aim To assess and improve compliance of time to initial consultant review for EGS admissions with the recommended standard by implementing twice daily versus once daily post take ward rounds (PTWR). Standard 100% of EGS admissions should have a consultant review within 14-hours of hospital admission. Methods Retrospective review of admission data and progress notes on the electronic medical record for all patients admitted under EGS from 00:00 Monday 26/9/2022 – 23:59 Friday 30/9/22 (identified from general surgery take list) three weeks post intervention. Data inputted onto a single audit tool and analyzed in Microsoft Excel in comparison to initial audit data (one month prior to intervention). Results Twice daily compared to once daily PTWRs improved compliance with the audit standard by 25%; 100% of patients reviewed within 14-hours. Longest time for initial consultant review decreased by 11hr 04min (20hr 56min to 09hr 52min). Number of patients reviewed in the emergency department by a consultant increased from 25% to 50%. Conclusions 100% of EGS patients can receive an initial consultant review in line with the nationally recommended timeframe with the introduction of twice daily versus once daily PTWRs.