Role of an acute assessment and review area for general surgical patients

Abstract

The introduction of a dedicated SARA significantly reduced hospital stay and improved efficiencies of the emergency department.

Index cholecystectomy for management of acute gallstone disease: a change of practice at a major New Zealand metropolitan centre

“…Total monthly bed days for all biliary disease patients have decreased over time, indicating overall benefits not only to patients, but also to the hospital. The introduction of a dedicated surgical assessment and review area (SARA) at Christchurch Public Hospital in March 2008 has been previously shown to have reduced hospital stay and improved inefficiencies in all acute surgical admissions 20 . This is not reflected in the preoperative bed day analysis for patients undergoing index cholecystectomy, in which time to acute theatre admission appears unchanged.…”

“…The introduction of a dedicated surgical assessment and review area (SARA) at Christchurch Public Hospital in March 2008 has been previously shown to have reduced hospital stay and improved inefficiencies in all acute surgical admissions. 20 This is not reflected in the preoperative bed day analysis for patients undergoing index cholecystectomy, in which time to acute theatre admission appears unchanged. The reduction in readmission rates brought about by a change in the practice of index cholecystectomy 10,17 is probably also reflected in the decrease in total monthly bed use.…”

Impact of acute care surgery on timeliness of care and patient outcomes: a systematic review of the literature

“…Hospital LOS was assessed in 19 studies. 10,[12][13][14][15][16][17][19][20][21][22][23][24][25][26][27][29][30][31] This measure was generally not clearly defined in these studies. Of the 8 studies that provided definitions, 4 looked at the time interval from inpatient admission to discharge, 3 considered the time from triage to discharge, and 1 mea sured emergency department arrival to discharge.…”

Modular acute system for general surgery: hand over the operation, not the patient

“…The published literature from Australasia has described numerous strategies for improving acute surgical care including alterations to surgical rosters, reorganization of available work space and dedicated acute surgical units 10–13 . The dedicated acute surgical unit has been shown to improve efficiency and enhance patient outcomes 10,14,15 .…”

“…9 The published literature from Australasia has described numerous strategies for improving acute surgical care including alterations to surgical rosters, reorganization of available work space and dedicated acute surgical units. [10][11][12][13] The dedicated acute surgical unit has been shown to improve efficiency and enhance patient outcomes. 10,14,15 Previous authors have also commented upon the positive changes in work culture at their respective institutions and increased satisfaction among those involved in the system.…”