Acute surgical unit: the Australasian experience

• Published in: ANZ journal of surgery Vol. 84; no. 1-2; pp. 25 - 30
• Main Authors: Page, Dean E., Dooreemeah, Dilshad, Thiruchelvam, Dhan
• Format: Journal Article
• Language: English
• Published: Australia Blackwell Publishing Ltd 01-01-2014
• Subjects: acute surgical unit; After-Hours Care; ASU; Australia; Clinical outcomes; Delivery of Health Care - organization & administration; Emergencies; emergency general surgical unit; Emergency medical care; Emergency Service, Hospital - organization & administration; emergency surgery; general surgery; General Surgery - organization & administration; Humans; Length of Stay; Models, Organizational; New Zealand; Outcome and Process Assessment (Health Care); Surgery; Surgery Department, Hospital - organization & administration; Surgical Procedures, Operative; New Zealand; Australia; Australasia; emergency surgery; general surgery; acute surgical unit; ASU; emergency general surgical unit
• ISSN: 1445-1433; 1445-2197
• DOI: 10.1111/ans.12473

Background
The acute surgical unit (ASU) model of care is a new paradigm shift in the provision of emergency surgery. Clinical and non‐clinical outcomes have been described after the introduction of the ASU model in Australia and New Zealand. This paper reviews and analyses the current published literature and methods of implementation of contemporary ASU models.
Method
We conducted a comprehensive database search to identify all relevant published papers pertaining to the ASU. Included papers compared ASU models to emergency surgery's traditional model of care. Relevant clinical and non‐clinical end points were extracted for analysis.
Results
Seven papers and two s published data assessing clinical and non‐clinical end points within the ASU. Four out of six studies reported a reduction in hospital length of stay. Two out of three studies showed reduction in mean time to emergency department review and two out of four studies reported a reduction in time to surgery. Additionally, four out of five studies showed a reduction in after hours operating with an ASU model.
Conclusion
Trends in clinical outcomes are seen including reduced length of stay, time to emergency department assessment and surgery, supplemented by non‐clinical outcomes including reduced after hours operating and the potential for increased training opportunities. The published data presents certain weaknesses and further information is required to appreciate the applicability of certain aspects of the ASU model to smaller centres.