Introduction of an acute surgical unit: Comparison of performance indicators and outcomes for operative management of acute appendicitis

Journal article


Lancashire, John F., Steele, Michael Craig, Parker, D. and Puhalla, H.. (2014) Introduction of an acute surgical unit: Comparison of performance indicators and outcomes for operative management of acute appendicitis. World Journal of Surgery. 38(8), pp. 1947 - 1953. https://doi.org/10.1007/s00268-014-2497-z
AuthorsLancashire, John F., Steele, Michael Craig, Parker, D. and Puhalla, H.
Abstract

Background: The Acute Surgical Unit (ASU) is a recent change in management of acute general surgical patients in hospitals worldwide. In contrast to traditional management of acute surgical presentations by a rotating on-call system, ASUs are shown to deliver improved efficiency and patient outcomes. This study investigated the impact of an ASU on operative management of appendicitis, the most common acute surgical presentation, by comparing performance indicators and patient outcomes prior to and after introduction of an ASU at the Gold Coast Hospital, Queensland, Australia. Methods: A retrospective study of patients admitted from the Emergency Department (ED) and who underwent emergency appendectomy from February 2010 to January 2011 (pre-ASU) and after introduction of the ASU from February 2011 to January 2012 (post-ASU). A total of 548 patients underwent appendectomy between February 2010 and January 2012, comprising 247 pre-ASU and 301 post-ASU patients. Results: Significant improvements were demonstrated: reduced time to surgical review, fewer complications arising from operations commencing during ASU in-hours, and more appendectomies performed during the daytime attended by the consultant. There was no significant difference in total cost of admission or total admission length of stay. Conclusions: This study demonstrated that ASUs have potential to significantly improve the outcomes for operative management of acute appendicitis compared to the traditional on-call model. The impact of the ASU was limited by access to theaters and restricted ASU operation hours. Further investigation of site-specific determinants could be beneficial to optimize this new model of acute surgical care.

Year2014
JournalWorld Journal of Surgery
Journal citation38 (8), pp. 1947 - 1953
PublisherSpringer New York LLC
ISSN0364-2313
Digital Object Identifier (DOI)https://doi.org/10.1007/s00268-014-2497-z
Page range1947 - 1953
Research GroupSchool of Allied Health
Place of publicationUnited States of America
EditorsJ.G. Hunter
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Prognostic value of semi-quantitative bacteruria counts in the diagnosis of group B streptococcus urinary tract infection: A 4-year retrospective study in adult patients
Tan, Chee K., Ulett, Kimberly B., Steele, Michael C., Benjamin, William H. and Ulett, Glen C.. (2012) Prognostic value of semi-quantitative bacteruria counts in the diagnosis of group B streptococcus urinary tract infection: A 4-year retrospective study in adult patients. BMC Infectious Diseases. 12(273), pp. 1 - 8. https://doi.org/10.1186/1471-2334-12-273
Using community surveillance data to differentiate between emerging and endemic amphibian diseases
Young, Sam, Skerratt, Lee F., Mendez, Diana, Speare, Rick, Berger, Lee and Steele, Michael Craig. (2012) Using community surveillance data to differentiate between emerging and endemic amphibian diseases. Diseases of Aquatic Organisms. 98(1), pp. 1 - 10. https://doi.org/10.3354/dao02416
The effect of physical training on systemic proinflammatory cytokine expression in heart failure patients: A systematic review
Smart, Neil A. and Steele, Michael Craig. (2011) The effect of physical training on systemic proinflammatory cytokine expression in heart failure patients: A systematic review. Congestive Heart Failure. 17(3), pp. 110 - 114. https://doi.org/10.1111/j.1751-7133.2011.00217.x
The immediate effect of unilateral lumbar Z-joint mobilisation on posterior chain neurodynamics :A randomised controlled study
Szlezak, Adam, Georgilopoulos, Peter, Bullock-Saxton, Joanne and Steele, Michael. (2011) The immediate effect of unilateral lumbar Z-joint mobilisation on posterior chain neurodynamics :A randomised controlled study. Manual Therapy. 16, pp. 609 - 613. https://doi.org/10.1016/j.math.2011.06.004
The impact of a temporary medical ward closure on emergency department and hospital service delivery outcomes
Crilly, Julia, Keijzers, Gerben B., Krahn, Dirken, Steele, Michael Craig, Green, David and Freeman, Janeen. (2011) The impact of a temporary medical ward closure on emergency department and hospital service delivery outcomes. Quality Management in Health Care. 20(4), pp. 322 - 333. https://doi.org/10.1097/QMH.0b013e318231355a
Exercise training in haemodialysis patients: A systematic review and meta-analysis
Smart, Neil and Steele, Michael Craig. (2011) Exercise training in haemodialysis patients: A systematic review and meta-analysis. Nephrology. 16(7), pp. 626 - 632. https://doi.org/10.1111/j.1440-1797.2011.01471.x
Tertiary survey performance in a regional trauma hospital without a dedicated trauma service
Keijzers, Gerben B., Campbell, Don, Hooper, Jeffrey, Bost, Nerolie, Crilly, Julia, Steele, Michael Craig, Eddington, Blake and Geeraedts, Leo M.G.. (2011) Tertiary survey performance in a regional trauma hospital without a dedicated trauma service. World Journal of Surgery. 35(10), pp. 2341 - 2347. https://doi.org/10.1007/s00268-011-1231-3
Access to and support for continuing professional education amongst Queensland nurses: 2004 and 2007
Hegney, Desley, Tuckett, Anthony, Parker, David and Robert, E. (2010) Access to and support for continuing professional education amongst Queensland nurses: 2004 and 2007. Nurse Education Today. 30(2), pp. 142 - 149. https://doi.org/10.1016/j.nedt.2009.06.015
Career breaks and intentions for retirement by Queensland's nurses-A sign of the times?
Eley, R., Parker, David, Tuckett, Anthony and Hegney, Desley. (2010) Career breaks and intentions for retirement by Queensland's nurses-A sign of the times? Collegian. 17(1), pp. 38 - 42. https://doi.org/10.1016/j.colegn.2009.10.004
Construct validity and reliability of the Practice Environment Scale of the Nursing Work index for Queensland nurses
Parker, David, Tuckett, Anthony, Eley, R. and Hegney, Desley. (2010) Construct validity and reliability of the Practice Environment Scale of the Nursing Work index for Queensland nurses. International Journal of Nursing Practice. 16(4), pp. 352 - 358. https://doi.org/10.1111/j.1440-172X.2010.01851.x
Workplace violence: Differences in perceptions of nursing work between those exposed and those not exposed: A cross-sector analysis
Hegney, Desley, Tuckett, Anthony, Parker, David and Eley, R. (2010) Workplace violence: Differences in perceptions of nursing work between those exposed and those not exposed: A cross-sector analysis. International Journal of Nursing Practice. 16(2), pp. 188 - 202. https://doi.org/10.1111/j.1440-172X.2010.01829.x
Evaluating the statistical power of goodness-of-fit tests for health and medicine survey data
Steele, M., Smart, N., Hurst, C. and Chaseling, J.. (2009) Evaluating the statistical power of goodness-of-fit tests for health and medicine survey data. In R.S. Anderssen, R.D. Braddock and L.T.H. Newham (Ed.). The 18th World IMACS Congress and MODSIM09 International Congress on Modelling and Simulation. United States of America: Modelling and Simulation Society of Australia and New Zealand and International Association for Mathematics and Computers in Simulation, July 2009. pp. 192 - 196
Regional differences among employed nurses: A Queensland study
Henwood, T., Eley, R., Parker, David, Tuckett, Anthony and Hegney, Desley. (2009) Regional differences among employed nurses: A Queensland study. Australian Journal of Rural Health. 17(4), pp. 201 - 207. https://doi.org/10.1111/j.1440-1584.2009.01072.x