Ipswich General Hospital, Australia
Scientific Tracks Abstracts: J Univer Surg
Introduction National Emergency Access Target (NEAT) in Queensland Australia has reportedly improved emergency department (ED) efficiency in clearing patients. However, patients subsequently referred onto surgical services have their overall health outcomes tied to more than just the care they receive within the ED. It is poorly understood what impacts, if any, NEAT has had on overall patient care. Aims To assess the impact of NEAT translating to improved surgical service outcomes at a Brisbane Hospital. Methods A retrospective review study reviewed data captured on the advanced integrated electronic Medical Record (ieMR) for a period of six months. The study group consisted of all ED presentations between May and November 2020 that were referred to general surgery. Outcome measures included time to surgical review, diagnosis, time to operation for abscess drainage and laparoscopy (appendicectomy) and time to other speciality review. Results 879 patient encounters were included, noting reduced encounters during the early COVID-19 pandemic period (p<0.01). Time to surgical review correlated with early ED referral. Average surgical review time was 25 minutes during standard hours, 15 minutes overnight, and 55 minutes on weekends, significantly different (p<0.3). Workup and diagnosis was associated with longer interval between patient arrival and referral. Time from presentation to operation was not impacted by early referral (p>0.09). Patient’s needing other speciality review had significantly longer wait times (p<0.02) especially if admitted to the ward (p<0.001). Conclusions NEAT has improved ED clearance efficiency. It has also seen early surgical reviews of patients. This has not correlated with efficiency in workup and diagnosis of patients. Overall surgical patient outcomes have not improved. Patients incompletely worked up requiring other speciality reviews were negatively impacted disproportionately.
Bawar Saeed is a General Surgery Registrar (trainee medical practitioner) for Queensland Health in Australia. He is a generally registered medical practitioner with the Australian Health Practitioner Regulation Agency (AHPRA). He has a Master in Traumatology specializing in Trauma Surgery from The University of Newcastle and Diploma of Surgical Sciences from Edinburgh University. He graduated from Bond University Australia with a MBBS and has been practicing and trained within Australian hospitals for the past 9 years with highly varied multidisciplinary hospital-based experience with 1.5 years as a Cardiothoracic Surgery Registrar and 3.5 years as a General SurgeryRegistrar.