Front-end specialists reduce time to a treatment plan for patients with acute abdomen.

INTRODUCTION Emergency departments (EDs) are replacing acute specialised wards in Denmark. The aim was to compare time to a treatment plan for patients with acute abdomen at a surgical assessment unit (SAU) and at an ED, respectively. MATERIAL AND METHODS A comparative prospective observational study was performed. The data collected included time to a doctor, a surgeon, a plan for treatment, analgesics, blood tests and time spent with health professionals. RESULTS The study included 109 patients. In the SAU, the median waiting time to be seen by a doctor was 72 min. and in the ED it was 86 min. (p = 0.25). The median time to be seen by a surgeon was 72 min. in the SAU and 148 min. in the ED (p ≤ 0.0001). In the SAU, the median time to a treatment plan was 131 min. and in the ED 166 min. (p = 0.02). In the SAU, patients spent 15 min. with nurses, in the ED 32 min. (p ≤ 0.0001). In the SAU, patients spent 11 min. with doctors in the ED 24 min. (p ≤ 0.0001). CONCLUSION Waiting time until a plan was presented to the patient was significantly shorter in the SAU than in the ED and this owed to the presence of a specialist surgeon at the hospital front-end in the SAU. The staff spent significantly more time with patients in the ED than in the SAU and significantly more blood tests were taken. FUNDING University of Southern Denmark, Odense University Hospital and Novo Nordisk Foundation.