The Royal United Hospital in Bath is speeding up the process of making patients better who suffer an urgent general surgical problem.
Urgent general surgical problems may include conditions such as appendicitis, gallstones, hernias, abscesses and pancreatitis.
A new urgent clinic – called the Emergency Surgical Ambulatory Clinic (ESAC) – has been designed specifically for patients suffering from these problems so that they can be seen, assessed, diagnosed and operated on as ‘one-stop-shop’, which avoids unnecessary hospital admissions and lengthy inpatient stays.
To their knowledge, they are the first hospital nationally to be managing emergency surgical patients in this way.
Emergency General Consultant Surgeon Sarah Richards, who leads the service, explained how it works.
She said: “The traditional process was that patients come in, investigations are ordered, there’s a queue, and then a further wait for a decision. If an operation is needed, there’s a further wait for that to be booked and a risk of cancellation, if something more urgent needs to take priority.
“The new clinic is really speeding things up – the RUH has provided resource not only for a Consultant Emergency Surgeon to oversee the service, but has also purchased a dedicated ultrasound machine and provided extra theatre capacity to operate on emergency patients.”
The new service is working really well and 788 patients were seen in the first six months. 71% of patients were seen and discharged home the same day, 12% of patients had their surgical procedure on the same day they were seen, and 6% of patients were added to the planned operating list for non-urgent surgery or were admitted to hospital.
Sarah continued: “We recognise that the majority of our patients don’t want to be admitted unless strictly necessary and this clinic is one of the many ways that the RUH is striving to work differently and more efficiently.
“The ESAC service is safe and effective and we have evidence that shows that it is contributing to a reduction in the time inpatients wait for emergency surgery. Managing general surgical patients in this way has also resulted in significant bed savings, as we’re avoiding unnecessary hospital admissions, which allows inpatient resources to be allocated to life-threatening emergencies.”
Patients have reported high levels of satisfaction. Of the 114 patients who completed the Friends and Family Test questionnaire, 99% of them said that they would be extremely likely, or likely, to recommend the service to friends and family if they needed similar care or treatment.
Examples of the feedback given by patients include: “Everything was just perfect. Overwhelmed by tender care and professionalism. Thank you so much,” and “I have been treated with respect and dignity at every point of care in the clinic. The staff and doctors are empathetic, compassionate and I really felt like they listened and understood. I had prompt care and treatment throughout. The clinic space was calm and very clean. Many thanks for all your care. Highly recommended.”
