Background: Increasing demand for acute surgical services is one of the major challenges facing modern health systems. The aim of this study was to assess the impact of implementing a dedicated surgical assessment and review area (SARA) on patient flow for acute general surgical patients at a major teaching hospital in New Zealand.
Methods: A specific area within inpatient surgical beds was redeveloped and staffed by a dedicated surgical team. Prospective data pertaining to patient flow and outcomes were collected (10-month period) and compared with historical controls (preceding 14 months prior to implementation).
Results: During the 24-month period 9182 acute general surgical patients were admitted (3836 [41.1%] post implementation of SARA). Subsequent to the introduction of SARA, 865 (22.5%) patients were referred directly from their general practitioner. Length of stay was reduced in all patients from 2.58 to 2.04 days (P < 0.001) and in those who did not require surgery from 2.56 to 1.96 days (P < 0.001). However, the number of days in which the department of surgery had outlying patients increased significantly from 76.7% to 86.3%, P < 0.001.
Conclusions: The introduction of a dedicated SARA significantly reduced hospital stay and improved efficiencies of the emergency department.
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