New approach cutting waiting times and hospital admissions for emergency patients

A year after opening a permanent Ambulatory Emergency Surgical Unit (AESU) at the Princess of Wales Hospital in Bridgend, treatment and assessment times have dramatically improved and there has been a reduction in the number of people needing to be admitted into hospital.

Ambulatory care means patients presenting to hospital as an emergency are assessed, diagnosed and treated on the same day and often discharged with ongoing clinical support and supervision as needed. Therefore, they do not need to be seen by separate clinicians throughout the hospital or require an inpatient stay.

Simon Weaver a consultant surgeon at the hospital explains: “Traditionally, surgical patients with emergency conditions presented to our Emergency Department (ED) where they would be assessed by a variety of staff with various investigations requested, before a decision was made on treatment. This can be time consuming leading to poor patient experience and often, to unnecessary hospital admission.”

“Ambulatory emergency care is an effective way of managing these demands and, following a hugely successful pilot, we are now running a permanent unit which is run by a team led and delivered by a senior nurse and a consultant surgeon.”

Since its launch last year, the unit has seen nearly 2500 patients, 80% of which were assessed, treated and discharged within three hours. Prior to the unit being set up, this figure was only 28%.

The ED itself has benefitted from less crowding and improved flow of patients.

The hospital admission rate for surgical patients assessed in this new way has reduced from 35% to 10%, and there has been a marked reduction in length of hospital stay demonstrated for patients suffering with appendicitis, skin abscess and emergency gall bladder conditions.

The unit is open Monday to Friday between 8am and 6pm.

Mr Weaver continued: “All calls from GPs wanting to refer a patient are being taken directly by a consultant – this not only improves our communication with colleagues in primary care, but in one in ten cases has led to no hospital attendance as GP colleagues are able to access senior surgical advice more rapidly. In one year, this has saved around 300 unnecessary hospital attendances. Additionally, direct telephone communication with GP colleagues about emergency patients has helped manage more of the complex patients who have challenging needs more appropriately. This has helped to facilitate rapid, real time diagnosis to target treatment.”

The AESU in Princess of Wales Hospital remains one of the few surgical units of its kind in Wales.