The impact of acute surgical unit rostering on National Emergency Access Targets during the COVID‐19 pandemic: a single hospital experience

• Published in: ANZ journal of surgery Vol. 92; no. 4; pp. 712 - 717
• Main Authors: Corbitt, Matthew, Wiener, Jonathan H., Swift, Kate, Do, Phuc (Richard), Wu, Roxanne
• Format: Journal Article
• Language: English
• Published: Melbourne John Wiley & Sons Australia, Ltd 01.04.2022; Blackwell Publishing Ltd
• Subjects: acute surgical; coronavirus; Coronaviruses; COVID-19; Emergency medical services; General Surgery; NEAT; outcomes; Pandemics; rostering; Statistical analysis; COVID-19; rostering; coronavirus; acute surgical; outcomes; NEAT
• ISSN: 1445-1433; 1445-2197
• DOI: 10.1111/ans.17498

Background Surgical departments have been dramatically impacted by the novel coronavirus 19 (COVID‐19) pandemic, with the cancellation of elective cases and changes to the provision of emergency surgical care. The aim of this study was to determine whether structural changes made within our facility's surgical department during COVID‐19 altered National Emergency Access Target (NEAT) times and impacted on patient outcomes. Methods Emergency surgical cases over a 4‐month time period were retrospectively collected and statistically analysed, divided into pre‐ and mid‐COVID‐19 pandemic. Results Baseline characteristics between the groups were comparable. There was a significant increase in consultant presence in theatre in the COVID group. There were also statistically significant reductions in NEAT times at each timepoint, although these did not meet national guidelines. There was no change in emergency surgical workload, complication rate or mortality rates within 30 days. Conclusion Any significant change to services requires a coordinated hospital‐wide approach, not just from a single department, and clinicians must continue to be wary of benchmarked times as the overall feasibility and safety of NEAT times has also been highlighted again. This study determined that after restructuring our surgical department to an ASU roster during mid‐COVID‐19, our National Emergency Access Target (NEAT) times improved, but not enough to meet national standards and there was no change in patient outcomes. Our results again indicate that any significant change to services requires a coordinated hospital‐wide approach, as well as highlight whether achieving NEAT times is actually feasible and safe.