Implementation of Acute Care Surgery Model at a Private Institution: Our Experience over a period of 6 months

Background: Acute Care Surgery units are an integral part of most tertiary Australian and New Zealand public hospital services.Several papers have outlined the importance of these units in a public hospital set up.However, there is minimal data on the implementation and outcomes of this model of care in a private hospital set-up. Methods:We set up a dedicated unit to evaluate the outcomes of acute care surgery in a private hospital setting.Three fellows of the Royal Australasian College of Surgeons were an integral part of the roster.Following ethics approval data was collected prospectively over a period of 6 months.Results: Over a period of 6 months there were 51 patients, 31 males with age range 11 to 90, American Society of Anaesthesiology grades from 1E to 4E.Average theatre access times ranged from 30 to 500 minutes depending upon time of presentation to emergency department and theatre availability.However, all patients requiring operative intervention underwent surgery prior to completion of 24 hours as an inpatient.Seven patients were managed with non-operative intervention.Two patients required readmission for a post-operative event not requiring surgical intervention.Conclusions: Given the increase in work load of acute care surgical units at public hospital there might be potential delays in access to operating theatres and thus increasing length of in hospital stay.Implementation of the acute care surgery model at private hospital set up might lead to overcome these potential road blocks.