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Acute‐care surgical service: a change in culture
Author(s) -
Parasyn Andrew D.,
Truskett Philip G.,
Bennett Michael,
Lum Sharon,
Barry Jennie,
Haghighi Koroush,
Crowe Philip J.
Publication year - 2009
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2008.04790.x
Subject(s) - medicine , acute care , service (business) , medical emergency , acute hospital , general surgery , emergency medicine , nursing , health care , economy , economics , economic growth
The provision of acute surgical care in the public sector is becoming increasingly difficult because of limitation of resources and the unpredictability of access to theatres during the working day. An acute‐care surgical service was developed at the Prince of Wales Hospital to provide acute surgery in a more timely and efficient manner. A roster of eight general surgeons provided on‐site service from 08.00 to 18.00 hours Monday to Friday and on‐call service in after‐hours for a 79‐week period. An acute‐care ward of four beds and an operating theatre were placed under the control of the rostered acute‐care surgeon (ACS). At the end of each ACS roster period all patients whose treatment was undefined or incomplete were handed over to the next rostered ACS. Patient data and theatre utilization data were prospectively collected and compared to the preceding 52‐week period. Emergency theatre utilization during the day increased from 57 to 69%. There was a 11% reduction in acute‐care operating after hours and 26% fewer emergency cases were handled between midnight and 08.00 hours. There was more efficient use of the entire theatre block, suggesting a significant cultural change. Staff satisfaction was high. On‐site consultant‐driven surgical leadership has provided significant positive change to the provision of acute surgical care in our institution. The paradigm shift in acute surgical care has improved patient and theatre management and stimulated a cultural change of efficiency.