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Emergency Undocking in Robotic Surgery: A Simulation Curriculum
Published on: May 20, 2018
Improving the efficiency of the emergency general surgical service
Catherine E Western1, James William Faux, Melanie Feldman
1The Royal Cornwall Hospital, Treliske, Truro, Cornwall, United Kingdom. catherinewestern@yahoo.co.uk
Objective:
To improve the quality and efficiency of our emergency surgical service.
Methods:
Until 2007, the surgical on-call in our unit was run on a 'consultant of the day' model with triage in a 10-bed surgical receiving unit (SRU) before admission to the wards. The reduction in junior doctors' hours meant little continuity and delays in care.In July 2007, the SRU was expanded and a daily on-ward ultrasound session was established. The consultant rota was changed to a split-week model with twice-daily SRU ward rounds, allowing unstable patients regular senior assessment.
Results:
As a result of the change, our acute length of stay reduced from 4.4 to 3.8 days and our actual versus expected length of stay was the best figure country-wide.
Conclusion:
Early consultant review and swift ultrasound assessment reduce admissions and patient stay. We have combined these factors in our emergency service and have delivered significant cost savings and improved care.