The Role Of General Surgical Registrars In Reducing Inter-Hospital Transfers For Emergency Surgical Referrals In A District Elective Surgical Hospital - A Victorian Multicenter Healthcare Network Experience.

Abstract

Casey Hospital (CH) is one of Southern Health (SH) centres offering elective surgical services in various specialties including general surgery. CH also has an emergency department, but does not have the resources to deal with emergency surgical patients. Referrals from the emergency department are referred to the general surgical registrar. In-hours (7.30 am to 5 pm on weekdays) patients are physically assessed by the rostered CH general surgical registrar whilst afterhours and weekend cases are discussed over the phone with a tertiary centre surgical registrar. Management decisions are then made over the telephone, including the need for transfer to the tertiary centre. The aim of our study was to look at the efficacy of having an after-hours surgical registrar in reducing inter-hospital transfers. We retrospectively reviewed all the surgical referrals made between May and July 2010. The time of referrals, type of assessment and the outcomes of patients were recorded. Our study showed that although physically-assessed patients were less likely to require transfer to a tertiary centre, the overall outcome compared to patients discussed over the telephone was not clinically significant to warrant the rostering of an after-hours surgical registrar in an elective hospital.