The Surgical Assessment Unit—Effective Strategy for Improvement of the Emergency Surgical Pathway?

• Published in: Journal of the Royal Society of Medicine 2005-01, Vol.98 (1), p.14-17
• Main Authors: Mohamed, M S, Mufti, G R
• Format: Article
• Language: English
• ISSN: 0141-0768; 1758-1095
• DOI: 10.1177/014107680509800105

A special unit was set up in an associate teaching hospital to provide a fast-track route for the assessment of acute adult surgical and urological referrals. During an audit period of eight weeks, this surgical assessment unit had 550 referrals, of which 196 (36%) came via the accident and emergency (A&E) department; the other 354 came directly from general practitioners or other hospital departments. Mondays, Tuesdays and Fridays were the busiest days of the week; 57% of all patients arrived between 8 am and 5 pm. 68% were seen by a doctor within 1 hour of their arrival. 68% were either discharged or admitted to the main surgical wards within 4 hours. The study showed that, over the course of a year, the surgical assessment unit might divert some 2301 patients away from the A&E department. To achieve this total it would need to be open and appropriately staffed 24 hours a day. Such a unit offers a strategy for limiting the A&E workload and streamlining the assessment of patients with surgical and urological emergencies.