The $2.4 million surgical assessment unit (SAU) provides a dedicated space where patients with acute surgical conditions, such as appendicitis or abscesses, can be assessed and begin treatment earlier.
The project was first proposed by nurse practitioner Bree Soper about three years ago, after experiencing the pressures of the ED, and knowing the difficulty to meet the targets of processing 95% of patients within six hours by 2030.
For many ED patients, one of the most harrowing aspects was the long wait with no sign of a specialist being available to see them, she said.
‘‘The key importance of having a nurse-led model is that, historically, patients who have been in ED — they’ll sit and wait for a surgeon who’s going to be stuck in surgery or they’re seeing unwell people on call,’’ Ms Soper said.
‘‘With this nurse-led model, patients can come up to the SAU and us clinical nurse specialists: we start those assessments.
‘‘So, we can assess the patient initially. We can order the blood tests. And then we liaise really, really closely with the surgical team.’’
The SAU has been introduced in stages, with initial trials beginning in December with three beds.
The SAU has five reclining chairs and six beds. It was fully operational, but expected to expand over time.
‘‘You can actually order CT scans, ultrasound scans, and start providing that treatment to the patient — pain relief fluids and things like that,’’Ms Soper said.
‘‘And this is really reducing the time that patients have to wait because everybody knows it’s awful being in ED, feeling unwell, and then the added frustration that you’re just sitting here and doing nothing.’’
Ms Soper said the early stages of promoting the idea involved a lot of ‘‘knocking on doors’’ and getting her paper to the right people.
Once a team was formed behind the proposal, they also were ‘‘lucky’’ that the government was looking at different ways to reduce ED processing times.
Dunedin Hospital medical director Mark Thompson-Fawcett said from a senior medical officer point of view, Ms Soper’s proposal was a ‘‘gift from the sky’’.
‘‘I’ve been involved in some really good proposals that get positive signals all the way to improved care, and they fall over at the final step.
‘‘So, getting this one over the line was great. But it was based around getting 95% of patients out of ED in six hours. And it was made clear very early on that you’ve got to deliver ... or you’re toast and the money’s gone.’’
More than 630 patients have already been treated in the unit and, with the hospital’s busier winter season approaching, the team was looking forward to seeing improved results, Mr Thompson-Fawcett said.
The initiative has been welcomed by Health Minister Simeon Brown, who was impressed with the ‘‘improved patient flow’’.
‘‘This nurse-led model ensures patients receive timely, qualified care from the moment they arrive,’’ he said.
‘‘Importantly, patients are either admitted from the unit directly to a surgical ward or able to return home with a clear plan if surgery or an inpatient stay isn’t required.’’
