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Improving the efficiency of the emergency general surgical service

Western, Catherine E.; Faux, James William; Feldman, Melanie

European Journal of Emergency Medicine: October 2011 - Volume 18 - Issue 5 - p 261–264
doi: 10.1097/MEJ.0b013e3283450758
ORIGINAL ARTICLES
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Objective To improve the quality and efficiency of our emergency surgical service.

Methods Until 2007, the surgical on-call in our unit was run on a ‘consultant of the day’ model with triage in a 10-bed surgical receiving unit (SRU) before admission to the wards. The reduction in junior doctors' hours meant little continuity and delays in care.

In July 2007, the SRU was expanded and a daily on-ward ultrasound session was established. The consultant rota was changed to a split-week model with twice-daily SRU ward rounds, allowing unstable patients regular senior assessment.

Results As a result of the change, our acute length of stay reduced from 4.4 to 3.8 days and our actual versus expected length of stay was the best figure country-wide.

Conclusion Early consultant review and swift ultrasound assessment reduce admissions and patient stay. We have combined these factors in our emergency service and have delivered significant cost savings and improved care.

Supplemental Digital Content is available in the text.

The Royal Cornwall Hospital, Treliske, Truro, Cornwall, United Kingdom

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's website (www.euro-emergencymed.com).

This work was presented at the association of Surgeons of Great Britain and Ireland Congress 2010. A copy of this presentation can be found at Supplemental Digital Content 1, http://links.lww.com/ejem/a9

This work was presented at the association of Surgeons of Great Britain and Ireland Congress 2010. A copy of this presentation can be found at Supplemental Digital Content 1, http://links.lww.com/ejem/a9

Correspondence to Catherine Elizabeth Western, BSc, MBBS, The Royal Cornwall Hospital, Treliske, Truro, Cornwall, TR1 3LJ, United Kingdom Tel: +77 88547537; fax: +18 72252708; e-mail: catherinewestern@yahoo.co.uk

Received September 9, 2010

Accepted January 26, 2011

© 2011 Lippincott Williams & Wilkins, Inc.