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Effect of handover on the outcomes of small bowel obstruction in an acute care surgery model
Author(s) -
Lien Ivy,
Wong Shing W.,
Malouf Phillip,
Truskett Philip G.
Publication year - 2014
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.1445-2197.2012.06248.x
Subject(s) - medicine , cohort , complication , retrospective cohort study , emergency medicine , bowel obstruction , acute care , adverse effect , surgery , general surgery , health care , economics , economic growth
Background An acute care surgery ( ACS ) model was introduced to manage emergency surgical presentations efficiently. The aim of this study was to evaluate the impact of patient handover in an ACS model on the outcomes of adhesive small bowel obstruction ( SBO ). Methods A retrospective study was performed on patients who were admitted with adhesive SBO at P rince of W ales H ospital. The cohort consisted of all patients treated by the ACS team from its introduction in S eptember 2005 to F ebruary 2011. Patients in the ACS cohort were divided into two groups: those whose care was handed over to another surgeon and those whose care was not. These groups of patients were compared with a random sample of 50 patients in the pre‐ ACS period. Results In the ACS period, there was no significant difference in complication rates or length of hospital stay in those who were not handed over and those who were. A significantly higher proportion of operations took place during the day for the group who had been handed over (72.7% versus 36.7%; P = 0.005). There were no significant differences in complication rates or length of hospital stay in the pre‐ ACS and ACS period. Conclusion Management under an ACS team does not increase adverse outcomes for adhesive SBO . Patients can be safely handed over within an ACS framework. Other members of the ACS team may help facilitate continuity of care.