Lack of timely assessment and access to acute operating rooms is a worldwide problem and also exists in New Zealand hospitals. To address these issues, an Acute Surgical Unit (ASU) was set up at Auckland City Hospital (ACH) in January 2009. This service has evolved and been modified to address the specific needs of acute surgical patients of ACH. Despite initial challenges inherent to setting up a new service, the Unit has been in steady operation and enhanced its performance over time. 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. Performance of the ASU has shown benefits for acute patients and the Hospital. The acute surgical rotation has also been beneficial for surgical training.

Our KPIs demonstrate an early positive trend of facilitating acute patient flow. There is minimal difference between pre- and post-ASU LOS[PO].The causes are likely multifactorial, including increased case volume displacing minor cases of lesser urgency, lack of operating staff, and shortage of hospital beds in winter months. This study supports the utility of ASU in facilitating patient flow in a NZ metropolitan public hospital.