Acute Surgical Unit: a new model of care

@article{Cox2010AcuteSU,
  title={Acute Surgical Unit: a new model of care},
  author={Michael R Cox and Lyn Cook and Jennifer Dobson and Paul Lambrakis and Shanthan Ganesh and Patrick Cregan},
  journal={ANZ Journal of Surgery},
  year={2010},
  volume={80}
}
The traditional on‐call system for the management of acute general surgical admissions is inefficient and outdated. A new model, Acute Surgical Unit (ASU), was developed at Nepean Hospital in 2006. The ASU is a consultant‐driven, independent unit that manages all acute general surgical admissions. The team has the same make up 7 days a week and functions the same every day, including weekends and public holidays. The consultant does a 24‐h period of on‐call, from 7 pm to 7 pm. They are on… 
View on Wiley
surgeons.org
64 Citations
Highly Influential Citations
3
Background Citations
22
Methods Citations
5
Results Citations
5

Topics from this paper

      64 Citations

      Citation Type

      Citation Type

      Response to Re: Is the acute surgical unit model feasible for Australian regional centres?
      TLDR
      Option 2 is to squeeze the after-hour emergency cases onto the next day’s elective list, but will also mean a delay in the patient care, and unnecessary occupation of a hospital bed for additional day.
      Acute Surgical Unit at Auckland City Hospital: a descriptive analysis
      TLDR
      This paper is a descriptive analysis of the design of the ACH ASU and discusses some of the indications for streamlining acute surgical services at a large tertiary metropolitan hospital in New Zealand.
      A model-based evaluation of the Canberra Hospital Acute Care Surgical Unit
      TLDR
      The implementation of a SAPU has benefited the management of patients with acute surgical conditions, with patients being reviewed, admitted, and treated earlier and time to the operating table and the percentage of after-hours operations reduced.
      Emergency general surgery and trauma: Outcomes from the first consultant-led service in Singapore.
      Provision of acute general surgery: A systematic review of models of care
      TLDR
      Currently available models in Europe, the United Kingdom, Australia and New Zealand for the provision of acute general surgical service and acute care surgery are reviewed, finding that patient care is satisfactory, continuity of care is maintained, and acute Care pathways function efficiently.
      Allocation of Extra Surgical Staff in Surgical Assessment Unit (SAU) - An Effective Strategy for Improvement?
      TLDR
      This study aimed to assess if the allocation of an extra registrar in surgical assessment unit would increase its efficiency, and found that waiting times were significantly shorter in the 2 reg group.
      Introduction of an Acute Surgical Unit: Comparison of Performance Indicators and Outcomes for Operative Management of Acute Appendicitis
      TLDR
      It is demonstrated that ASUs have potential to significantly improve the outcomes for operative management of acute appendicitis compared to the traditional on-call model.
      Key Performance Indicators in an Acute Surgical Unit: Have We Made an Impact?
      TLDR
      The utility of the Acute Surgical Unit in facilitating patient flow in a NZ metropolitan public hospital is supported and an early positive trend of facilitating acute patient flow is demonstrated.
      Acute care surgery: what's in a name? A new specialty comes of age.
      TLDR
      The discipline of acute care surgery represents a fusion of trauma surgery, surgical critical care, and emergency surgery, and the core principles remain the same, although the actual surgical responsibilities of the ACS surgeon may vary, depending on local institutional needs.
      Impact of an acute surgical unit on patient outcomes in South Australia
      Compared with traditional (Trad) systems of managing emergency surgical presentations, the acute surgical unit (ASU) model provides an on‐site registrar, on‐call surgeon and dedicated emergency…
      ...
      1
      2
      3
      4
      5
      ...

      References

      SHOWING 1-10 OF 10 REFERENCES
      Acute‐care surgical service: a change in culture
      TLDR
      On‐site consultant‐driven surgical leadership has provided significant positive change to the provision of acute surgical care in the Prince of Wales Hospital and stimulated a cultural change of efficiency.
      Initial implementation of an acute care surgery model: implications for timeliness of care.
      Acute Care Surgery: A New Training and Practice Model in the United States
      TLDR
      The evolution of a new specialty and some of the challenges and opportunities associated with the implementation of this model of “Acute Care Surgery” are identified.
      Acute Care Surgery: The European Model
      TLDR
      There is no European consensus on acute care surgery; in some central European countries, specialists qualify in general and orthopedic trauma surgery; these allrounders also perform life-saving thoracic and neurosurgical procedures, such as emergency thoracotomy and craniotomies.
      Time-of-day effects on surgical outcomes in the private sector: a retrospective cohort study.
      TIME FOR A CHANGE IN INJURY AND TRAUMA CARE DELIVERY: A TRAUMA DEATH REVIEW ANALYSIS
      TLDR
      Age, severity of injury, hospital length of stay and care by a non‐trauma surgeon are factors associated with avoidable deaths, and a new approach to trauma and injury care is required.
      Sub‐specialization in general surgery: the problem of providing a safe emergency general surgical service
      TLDR
      To evaluate the size of the problem, this study determined how often complex emergency surgical cases are treated by general surgeons working outside their own elective subspecialty.
      Performance and consistency of care in admitted trauma patients: our next great opportunity in trauma care?
      TLDR
      This study undertook a prospective analysis of performance and consistency of care at a Level 1 trauma centre.
      Emergency surgery guidelines
      • NSW Surgical Services Taskforce , NSW Health , October
      • 2009
      Acute care surgery: a functioning program and fellowship training.