DOI: 10.1093/bjs/znad258.494 ISSN:

316 The Impact of a Surgical Same Day Emergency Care (SDEC) Unit

A Lukaszewicz, S Linganathan, C Morris, P Strong
  • Surgery

Abstract

Aim

SDEC units are part of the NHS long term plan. It marks a shift from assessment units to tailored emergency care hubs providing genuine dual assessment and treatment. Its aim is to provide optimal care for patients in a timely manner by the appropriate teams, enabling reduced time to emergent treatment, reduced pressure on other acute services and shorter inpatient stays. This is ever more pertinent in the modern, post-pandemic NHS with staffing and funding challenges combining with record numbers of expectant patients awaiting urgent operations. This QIP aims to investigate one such unit’s effectiveness.

Method

SDEC surgical admissions data was collected from the online system BIS or from the clinical notes between September 2021-2022. This was then graphed on excel and analysed.

Results

Pertinent findings include: 47% drop in ED surgical presentations. 66% surgical emergency attendances seen in SDEC (43% prior to SDEC). Decision to admit time reduced by 150 minutes. Median time from arrival to discharge reduced by 7 hours.

Conclusions

This SDEC unit has had a positive impact on ED workload and improving decision making & throughput of surgical patients. As well as supporting previous studies on SDEC benefits this model works for all surgical specialties. It is also objective and repeatable, allowing like-for-like comparison. Limitations include short study period, and lack of patient satisfaction assessment. It is also unclear which specific elements of SDEC model have had the beneficial effects.

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