AB109. SOH24AB_106. Audit of acute surgical assessment unit as per national key performance indicator

Background: Acute surgical assessment unit (ASAU) opened in University Hospital Limerick (UHL) in 2010. ASAUs in UHL have capacity of 24 patients with 15 bays for patients, 1 examination room and 9 patients can sit in waiting area. ASAU was converted to surgical emergency department (ED) over the period of covid. Most of the specialties are reverted back to ED. At present ASAU in UHL entertained patients from ED, general practitioner (GP) and planned return patients. The aim of this audit is to compare ASAU services as per national key performance indicator (KPI).

Methods: The audit carried out for patient presented to ASAU in routine working hours from Monday to Friday. Standard Performa was made. The audit Performa was discussed with working staff including nurses, certified nurse-midwife (CNM) in charge and surgical doctors. The patients included in audit were only surgical patients presented to ASAU. The KPI included were patient experience time, admission percentage, clinic review, triage categories and patient satisfactions.

Results: The patient total experience time in 70% of the patients were less than 4 hours against the national standard of 80 percent. The data for three patients was missing with longest waiter of 7.23 hours. Total admissions were 26 percent against the national standard of less than 60 percent (data duration not meet national standard duration for 1 month). Patient review in ASAU is 29 percent in less than 3 hours against national standard of 80 percent. None of the patients were category 5. Patients’ satisfaction data showed more than 82 percent satisfaction. Number of patients were less than national standard.

Conclusions: Record keeping in ASAU needs improvement. All data were collected manually. National standard KPI should be in cooperated electronically in integrated patient management system (IPMS). Some record was missing because of short staffed. Some patients were reviewed, even without checking in the system. Results of blood investigation and radiology delayed in decision making. Concept of clinical room to lessen the review time. Staff education to make a smooth flow of patients. The recommendations were made and discussed to make improvement in service.

Keywords: National key performance indicator (national KPI); acute surgical assessment unit (ASAU); patient experience time; admissions; patient review