Allocation of Extra Surgical Staff in Surgical Assessment Unit (SAU) - An Effective Strategy for Improvement?

Abstract

Background: SAU is a recognized model of care in managing acute surgical patients, but limited resources and growing workload are affecting its efficiency. This study aimed to assess if the allocation of an extra registrar in surgical assessment unit would increase its efficiency. Methods: We routinely record patient arrival, triage, junior doctor (house officer/senior house officer) and senior doctor review (registrar) times in our SAU. Data was collected retrospectively for all general surgical patient waiting times and number of patients discharged in June/July 2018 over 20 days. In the second part of the study, after allocation of a second duty registrar during peak times (14:00-18:00hrs), data was prospectively collected for the same parameters during June/July 2019. In both cycles of study, the data was collected from Monday to Friday between (08:00-20:00 hours). This allowed us to compare both sets of data fairly. We statistically analysed the data using 2 tailed t tests. Results: The total number of patients in 1reg and 2reg studies were 182 and 196 respectively. In the 1reg group, the mean waiting times from patient triage to senior doctor review and junior to senior doctor review were 154 and 121 minutes respectively. These times were 110 and 75 minutes respectively in the 2reg group. Statistical analysis revealed that waiting times were significantly shorter (p=0.001, P=0.0003) in the 2 reg group. The number of patients discharged