I. Lien; S. W. Wong FRACS, MS; P. Malouf MBBS, FRACS; P. G. Truskett MBBS, FRACS.
UPPER GI SURGERY
Effect of handover on the outcomes of small bowel obstruction in an acute care surgery model
Version of Record online: 17 SEP 2012
© 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons
ANZ Journal of Surgery
Volume 84, Issue 6, pages 442–447, June 2014
How to Cite
Lien, I., Wong, S. W., Malouf, P. and Truskett, P. G. (2014), Effect of handover on the outcomes of small bowel obstruction in an acute care surgery model. ANZ Journal of Surgery, 84: 442–447. doi: 10.1111/j.1445-2197.2012.06248.x
- Issue online: 3 JUN 2014
- Version of Record online: 17 SEP 2012
- Manuscript Accepted: 11 JUL 2012
- general surgery;
- intestinal obstruction;
- patient transfer;
- post-operative complication
An acute care surgery (ACS) model was introduced to manage emergency surgical presentations efficiently. The aim of this study was to evaluate the impact of patient handover in an ACS model on the outcomes of adhesive small bowel obstruction (SBO).
A retrospective study was performed on patients who were admitted with adhesive SBO at Prince of Wales Hospital. The cohort consisted of all patients treated by the ACS team from its introduction in September 2005 to February 2011. Patients in the ACS cohort were divided into two groups: those whose care was handed over to another surgeon and those whose care was not. These groups of patients were compared with a random sample of 50 patients in the pre-ACS period.
In the ACS period, there was no significant difference in complication rates or length of hospital stay in those who were not handed over and those who were. A significantly higher proportion of operations took place during the day for the group who had been handed over (72.7% versus 36.7%; P = 0.005). There were no significant differences in complication rates or length of hospital stay in the pre-ACS and ACS period.
Management under an ACS team does not increase adverse outcomes for adhesive SBO. Patients can be safely handed over within an ACS framework. Other members of the ACS team may help facilitate continuity of care.