Separating elective and emergency surgical care (the emergency team)

Area of Science:

• General Surgery
• Surgical Management
• Hospital Operations

Background:

• General surgical departments face challenges managing both elective and emergency patient care.
• The separation of surgical services aims to optimize resource allocation and patient outcomes.
• A large teaching hospital implemented a dedicated emergency surgical team to address these challenges.

Purpose of the Study:

• To evaluate the impact of separating elective from emergency general surgical care.
• To assess changes in surgical activity, patient admissions, and operative procedures.
• To determine the efficiency of a dedicated emergency surgical team model.

Main Methods:

• Prospective audit of general surgical activity from 1994-1999.
• Data collection on elective and emergency operations, outpatient, and day case activity.
• Comparison of surgical metrics before and after the implementation of the 'Emergency Team' in January 1996.

Main Results:

• Emergency surgical admissions increased by 86% (1973 to 3675 patients).
• Day surgery cases significantly increased (469 to 2089 per annum).
• Out-of-hours emergency operations reduced by half (16% to 7.9%), with a decrease in late-night procedures.

Conclusions:

• A dedicated 'Emergency Team' model is an efficient approach for managing acute general surgery.
• This separation allows elective procedures to continue uninterrupted.
• The model improves teaching environments and may be applicable to other surgical specialties.