The impact of a surgical assessment unit on numbers of general surgery outliers

Abstract

Patient care and efficiency outcomes are improved if acute patients admitted to non-specialty (outlier) wards are minimised.1 Assessment units may help to reduce numbers of outlier patients.2 A surgical assessment unit (SAU) was recently established at Middlemore Hospital. We aimed to determine the impact of its introduction on numbers of general surgery outliers on post-acute ward rounds.A 10-bed SAU was introduced in July 2015, coinciding with the closure of 20 beds on the general surgical wards. The numbers and locations of patients on post-acute ward rounds before and after the establishment of the SAU were compared. A student two-tailed t-test was used for statistical comparisons, with p<0.05 considered significant.A total of 1,462 patient locations were analysed from 71 post-acute ward rounds. There were similar overall numbers of post-acute patients before and after the introduction of the SAU (mean 21 vs 20, p=0.33). There were fewer post-acute patients in outlier wards after the introduction of the SAU (mean 1.7 before vs 0.8 after, p=0.04).Despite a net reduction in general surgery beds and no change in the overall number of post-acute patients, the establishment of a SAU was associated with a reduction in outliers.