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Improved patient outcomes at a Level 1 Trauma Centre


Improved patient outcomes at a Level 1 Trauma Centre

Wednesday 8 May, 2013

Further evidence has emerged that the introduction of dedicated, consultant-led acute care surgical centres results in markedly improved patient outcomes.

Speaking at the 82nd Annual Scientific Congress (ASC) of the Royal Australasian College of Surgeons, Dr Rose Shakerian, a General Surgeon at the Royal Melbourne Hospital, reported that an Emergency General Surgery Service (EGS) was established at the hospital in 2011, in response to an increased volume of acute general surgical and trauma cases.

“The aim of this study was to assess the impact of the new EGS service on length of stay, and admission to the ward from the Emergency Department, and to compare these outcomes with those of the traditional model,” Dr Shakerian said.

“Using our prospective surgical audit database, we performed a retrospective review of patients admitted to the EGS from February 2011 to January 2012 (a 48 week period) and these outcomes were compared with those of the previous 48 weeks.

“A 73% increase was noted in the total number of admissions, from 1193 pre-EGS to 2065 patients since the introduction of the EGS service. With the inclusion of inpatient referrals (411 patients) and Trauma admissions (2047 patients), the EGS service managed 4523 patients during the study period.

“Hospital length of stay was reduced from 5 to 4.1 days (18% reduction) and a 20% improvement was noted in the proportion of patients admitted from the Emergency Department within eight hours (49% vs 69%). The percentage of surgical cases conducted in hours was found to be 50%.”

Dr Shakerian concluded that early and increased consultant input reduced length of stay and time spent in the Emergency Department, despite the 73% increase in acute admissions during the introduction of the new service.

In 2011, the Royal Australasian College of Surgeons wrote to all health ministers and senior health department officials in Australia and New Zealand, enclosing a comprehensive report which demonstrated that the establishment of dedicated acute care surgical units leads to greater efficiency and better patient outcomes.

Approximately 1200 surgeons from New Zealand, Australia and around the world are attending the ASC, which runs from 6 to 10 May and is being held at Auckland’s Skycity/Crowne Plaza Convention Centre.


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