Improving the efficiency of the emergency general surgical service. 2011

Catherine E Western, and James William Faux, and Melanie Feldman
The Royal Cornwall Hospital, Treliske, Truro, Cornwall, United Kingdom. catherinewestern@yahoo.co.uk

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. CONCLUSIONS 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.

UI MeSH Term Description Entries
D007902 Length of Stay The period of confinement of a patient to a hospital or other health facility. Hospital Stay,Hospital Stays,Stay Length,Stay Lengths,Stay, Hospital,Stays, Hospital
D010343 Patient Admission The process of accepting patients. The concept includes patients accepted for medical and nursing care in a hospital or other health care institution. Voluntary Admission,Admission, Patient,Admission, Voluntary,Admissions, Patient,Admissions, Voluntary,Patient Admissions,Voluntary Admissions
D011787 Quality of Health Care The levels of excellence which characterize the health service or health care provided based on accepted standards of quality. Pharmacy Audit,Quality of Care,Quality of Healthcare,Audit, Pharmacy,Care Quality,Health Care Quality,Healthcare Quality,Pharmacy Audits
D011872 Radiology Department, Hospital Hospital department which is responsible for the administration and provision of x-ray diagnostic and therapeutic services. Hospital Radiology Department,X-Ray Departments,Department, Hospital Radiology,Department, X-Ray,Departments, Hospital Radiology,Departments, X-Ray,Radiology Departments, Hospital,X-Ray Department,Department, X Ray,Departments, X Ray,Hospital Radiology Departments,X Ray Department,X Ray Departments
D003422 Critical Care Health care provided to a critically ill patient during a medical emergency or crisis. Intensive Care,Intensive Care, Surgical,Surgical Intensive Care,Care, Critical,Care, Intensive,Care, Surgical Intensive
D004059 Diffusion of Innovation The broad dissemination of new ideas, procedures, techniques, materials, and devices and the degree to which these are accepted and used. Innovation Diffusion,Diffusion, Innovation
D004638 Emergency Treatment First aid or other immediate intervention for accidents or medical conditions requiring immediate care and treatment before definitive medical and surgical management can be procured. Emergency Therapy,Therapy, Emergency,Emergency Therapies,Emergency Treatments,Therapies, Emergency,Treatment, Emergency,Treatments, Emergency
D006113 United Kingdom Country in northwestern Europe including Great Britain and the northern one-sixth of the island of Ireland, located between the North Sea and north Atlantic Ocean. The capital is London. Great Britain,Isle of Man
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014218 Triage The sorting out and classification of patients or casualties to determine priority of need and proper place of treatment. Triages

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