Surgical Assessment Units: The Key to More Efficient Emergency Surgical Provision and Admissions?

Hospitals establish surgical assessment units to promote efficiency and improve patient experience. Surgical assessment units are believed to reduce unnecessary admissions. We evaluated a hospital's on-call surgery service without this facility to determine benefits of implementation.

All emergency surgery referrals made over a 3-month period were recorded, including whether the patient was immediately discharged directly from emergency surgery. Data collection was undertaken by each surgical firm on-call. Immediate discharges were classed as patients not admitted to the hospital overnight (regardless of whether the patient had outpatient follow-up planned).

Nine hundred eighty-four referrals were identified. Seven hundred ninety-three referrals had complete data and therefore were included for analysis. Of these, 349 patients (44.0% of referrals) were immediately discharged from emergency surgery, thereby preventing unnecessary admissions (a high proportion of surgical referrals not requiring hospital admission). This improves hospital efficiency, cost savings, and patient experience. Immediate discharge was less frequent and more difficult to accomplish if patients were initially assessed on wards (instead of in the emergency department). This is likely due to patients' perceptions that admission was required when transferred from emergency department to a ward.

Establishment of surgical assessment units has multiple potential benefits to patients, hospitals and clinicians. Appropriateness of surgical assessment unit implementation by every hospital ought to be evaluated.