Featured Research

from universities, journals, and other organizations

Urgent assessment in emergency departments can reduce surgical decision time and overcrowding

Date:
August 8, 2011
Source:
American College of Surgeons
Summary:
The use of acute care emergency surgical service (ACCESS) in emergency departments (EDs) can lead to significant reductions in key patient measures, such as length of stay, surgical decision-making time and "time-to-stretcher" (one measure of overall ED overcrowding), according to a new study.

The use of Acute Care Emergency Surgical Service (ACCESS) in emergency departments (EDs) can lead to significant reductions in key patient measures, such as length of stay, surgical decision-making time and "time-to-stretcher" (one measure of overall ED overcrowding), according to a study published in the August issue of the Journal of the American College of Surgeons. Emergency departments are a crucial point of access to the health care system for patients with a broad spectrum of injuries and illnesses, and overcrowding has been identified as a widespread and serious problem with adverse consequences, both in the United States and Canada.

Related Articles


"This study is the first to show that the establishment of an acute care surgery service can improve overall ED overcrowding by decreasing surgical decision time for all general surgery patients," said Homer Tien, MD, MSc, FACS, FRCSC and associate scientist at the Sunnybrook Health Sciences Centre, University of Toronto, and a senior author of the study. "In the past five years, there has been a groundswell of support in both Canada and in the U.S. for establishment of these services for various reasons, such as the growing difficulty of treating acute surgical conditions and a decrease in operative trauma surgical cases."

The researchers found that implementation of ACCESS was associated with a 15 percent reduction in surgical decision time (12.6 hours vs. 10.8 hours, p < 0.01) and a 20 percent decrease in the average "time-to-stretcher" for all ED patients. The researchers also focused on an isolated group of appendicitis cases and found ACCESS service reduced surgical decision time by 30 percent for these patients. The study was performed between January 1, 2007, and June 30, 2009, at Sunnybrook Health Sciences Centre, a large academic hospital located in Toronto that receives approximately 42,000 ED visits annually. ACCESS was implemented in the ED on July 1, 2008 and 2,510 patients took part in the study. There were 1,448 patients studied pre-ACCESS and 1,062 studied post-ACCESS implementation. The primary study outcome was surgical decision time; the secondary outcome was a measure of overall ED overcrowding.

In order to better understand the key factors contributing to overcrowding, study authors developed a conceptual model that partitioned ED overcrowding into three interdependent components: input, throughput and output. The input component refers to factors that contribute to the volume of care delivered in the ED. The throughput component refers to factors that contribute to the amount of time a patient spends in the ED. The two main options for output are admission to a hospital bed or discharge. The inability to move patients from the ED to an inpatient bed is considered one of the major contributing factors to ED overcrowding.

Acute care surgery is defined as the urgent assessment and treatment of non-trauma general surgical emergencies (i.e., appendicitis, diverticulitis, bowel obstruction, bilary disease, postoperative complications).


Story Source:

The above story is based on materials provided by American College of Surgeons. Note: Materials may be edited for content and length.


Journal Reference:

  1. Adnan Qureshi, Andy Smith, Frances Wright, Fred Brenneman, Sandro Rizoli, Taulee Hsieh, Homer C. Tien. The Impact of an Acute Care Emergency Surgical Service on Timely Surgical Decision-Making and Emergency Department Overcrowding. Journal of the American College of Surgeons, 2011; 213 (2): 284 DOI: 10.1016/j.jamcollsurg.2011.04.020

Cite This Page:

American College of Surgeons. "Urgent assessment in emergency departments can reduce surgical decision time and overcrowding." ScienceDaily. ScienceDaily, 8 August 2011. <www.sciencedaily.com/releases/2011/08/110808152419.htm>.
American College of Surgeons. (2011, August 8). Urgent assessment in emergency departments can reduce surgical decision time and overcrowding. ScienceDaily. Retrieved March 5, 2015 from www.sciencedaily.com/releases/2011/08/110808152419.htm
American College of Surgeons. "Urgent assessment in emergency departments can reduce surgical decision time and overcrowding." ScienceDaily. www.sciencedaily.com/releases/2011/08/110808152419.htm (accessed March 5, 2015).

Share This


More From ScienceDaily



More Health & Medicine News

Thursday, March 5, 2015

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Doctor in Your Pocket Is Getting Smarter

Doctor in Your Pocket Is Getting Smarter

Reuters - Business Video Online (Mar. 5, 2015) Mobile apps are turning smartphones into a personal doctors, with users able to measure heart rate, blood pressure and even blood sugar. But will it change our behaviour? Ivor Bennett reports from the Mobile World Congress in Barcelona. Video provided by Reuters
Powered by NewsLook.com
AbbVie Inks $21B Deal To Buy Cancer Drugmaker Pharmacyclics

AbbVie Inks $21B Deal To Buy Cancer Drugmaker Pharmacyclics

Newsy (Mar. 5, 2015) AbbVie announced Wednesday it will buy cancer drugmaker Pharmacyclics in a $21 billion deal. Video provided by Newsy
Powered by NewsLook.com
Adults Only Get The Flu Twice A Decade, Researchers Say

Adults Only Get The Flu Twice A Decade, Researchers Say

Newsy (Mar. 4, 2015) Researchers found adults only get the flu about once every five years. Scientists analyzed how a person&apos;s immunity builds up over time as well. Video provided by Newsy
Powered by NewsLook.com
Obamacare's Strange New Supreme Court Case

Obamacare's Strange New Supreme Court Case

Newsy (Mar. 4, 2015) President Obama&apos;s healthcare law is facing its second Supreme Court challenge, and it hinges on a single sentence. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins