Cohort study on emergency general surgery patients and an observation unit

BACKGROUND: Medium-sized, non-trauma hospitals experience many of the same difficulties as tertiary centres do when it comes to managing emergency general surgery patients. However, acute surgical units are not a financially viable option in these hospitals. To improve the care of emergency general surgery patients at one such hospital, a Rapid Assessment Medical Surgical (RAMS) unit was developed to decrease the time to review and increase the efficiency in caring for these patients. METHODS: To assess the unit's effect, a prospective analysis was completed of the patients who came through the RAMS unit over a 6-month period and compared with a retrospective analysis of patients presenting in the same 6-month period the year prior to the unit's instigation. RESULTS: The RAMS unit was effective in providing an avenue for faster review by the surgical team. This resulted in patients leaving the emergency department faster, decreased the number of patients that breached emergency department time-targets and increased the number of patients discharged after a period of observation or basic treatments. CONCLUSION: General surgery patients were managed more efficiently with the RAMS unit in place. However, a full cost analysis is required to determine if such units are cost-effective.