• Ivy Lien, Shing W Wong, Phillip Malouf, and Philip G Truskett.
• Department of Surgery, Prince of Wales Hospital, Sydney, New South Wales, Australia; University of New South Wales, Sydney, New South Wales, Australia.
• ANZ J Surg. 2014 Jun 1; 84 (6): 442-7.

BackgroundAn 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).MethodsA 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.ResultsIn 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.ConclusionManagement 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.© 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

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