Up to 4,800 bed days could be freed up every year at University College Hospital Galway (UCHG) if an acute surgical unit was established at the hospital, according to a new study.
Acute surgical units, which are common in the UK, are a facility for the rapid assessment, diagnosis and treatment of emergency surgical patients arriving in hospital who might otherwise have to spend long periods in A&E.
The initiative was tested at UCHG for six weeks earlier this year and it emerged during the study period that patients who used it were treated more quickly, admitted to a bed in a much shorter timeframe, and had shorter lengths of stay in hospital than those admitted by the traditional route.
The admissions of 151 patients were recorded as part of the pilot study - around one-third of them were admitted directly to the unit after triage in A&E, a third waited to be seen by A&E doctors before being sent to the unit and the final third went through the normal process of sitting in A&E for some time before being admitted to a bed in the main hospital rather than to the acute surgical unit.
The study found that patients admitted directly to the acute surgical unit had a mean waiting time of 1.8 hours from registration at the front desk to being admitted to a bed; patients who were seen by A&E doctors before being sent to the unit had a mean waiting time of 6.5 hours from registration to a bed; and patients who went through the normal hospital pathway and never saw the acute surgical unit had a mean waiting time from registration to reaching a ward bed of 8.6 hours.
Furthermore, the mean hospital stay for patients admitted directly to the acute surgical unit was 4.35 days, which was 1.3 days shorter than for patients admitted through the usual A&E admissions process.
The study concluded that the shorter lengths of stay for these patients could, if the study was extended over a full year, potentially free up 4,800 beds.
"An acute surgical unit facilitates rapid, more effective care for patients, minimising A&E delays, shortening length of stay and potentially freeing up an additional 25 per cent bed capacity as a result of shorter admissions," the research report said.
A number of patients who were admitted to the unit were followed up later and their views sought. Some 27 patients responded to the telephone questionnaire and 47 per cent of them rated their experience as excellent while a further 26 per cent rated their experience as good. Just two patients rated their experience as poor or very poor.
The unit was open around the clock seven days a week from mid-July to the end of August, seeing patients with conditions ranging from suspected appendicitis to those with gallstones.
The findings of the study have been submitted to the A&E taskforce and the hospital hopes it will recommend that an acute surgical unit be funded at the hospital on an ongoing basis.