Abstract
BackgroundAcute surgical assessment units (ASAUs) aim to optimise management of surgical patients compared to the traditional ‘on-call’ emergency department (ED) system. Acute appendicitis (AA) is the most common acute surgical condition requiring emergency surgery.AimWe set out to assess if the ASAU improved care provided to patients with AA compared to those managed through the ED.MethodsPatients admitted via the ED with AA in the 6 months prior to opening the ASAU were compared to those admitted via the ASAU in the first six months following its implementation. Relevant data was collected on key performance indicators from their charts.ResultsIn the ASAU cohort, the mean time to be seen was one hour less than the ED cohort (21 min vs 74 min). The mean time to surgery was also 8.8 h shorter. Most patients in the ASAU group (78.6%) underwent surgery during the day, compared to 40.3% of ED patients. The ASAU patients also had a lower postoperative complication rate (0.9% vs 3.9%), as well as a lower negative appendicectomy rate (14.2% vs 18.6%) and lower conversion-to-open surgery rate. Greater consultant supervision and presence was observed. ConclusionsThe ASAU has resulted in better outcomes for patients with AA than those admitted via ED. More operations were performed in safer daytime hours with greater consultant presence, allowing for improved senior support for trainee surgeons. Our study supports the role of the ASAU in improving the quality and efficiency of emergency general surgery.
Highlights
Emergency general surgery (EGS) represents more than 50% of the surgical workload and 80% of surgical deaths [1, 2]
This study aimed to investigate the impact of the implementation of the Acute surgical assessment units (ASAUs) model of care on the management of appendicitis in our hospital by comparing key performance indicator (KPI) and clinical outcomes to that of the traditional ‘on call’ emergency department (ED) model of care that was in place prior to the opening of the ASAU
In the 6 months prior to opening the ASAU, 102 patients were admitted through the ED with a diagnosis of Acute appendicitis (AA) which was managed by appendicectomy (ED group)
Summary
Emergency general surgery (EGS) represents more than 50% of the surgical workload and 80% of surgical deaths [1, 2]. The traditional means of managing EGS patients is the ‘on call’ system, whereby patients are assessed in the emergency department (ED) by a surgical team providing 24-h emergency cover. This is while being expected to attend to elective duties such as theatre lists, ward rounds, outpatient clinics, surgical consults and administrative work. With such a heavy burden of tasks and without dedicated time on call, delays in care for acute surgical patients are unavoidable [1, 2]. Our study supports the role of the ASAU in improving the quality and efficiency of emergency general surgery
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
