319 An Audit on Calls to Surgical ACU Consultants: Frequency, Outcomes Andpathway Appropriateness in Altnagelvin Hospital

Abstract Aim To evaluate the referral patterns, triage outcomes, and documentation practices of consultant-led calls to the Acute Surgical Ambulatory Care Unit (ASACU), and to identify areas for improvement in service delivery and governance. Method A prospective audit was conducted between 14/04/2025 and 09/05/2025. Consultants covering ASACU logged all incoming clinical calls in real-time over a 13-day period. Data collected included the source of contact, triage outcome, and whether the call was formally documented. A total of 45 calls were captured and analysed. Results General Practitioners initiated 78% of the calls, highlighting primary care as the predominant referral source. Only 2 calls originated from the Emergency Department. Of the 45 calls, 24 (53%) resulted in ASACU referrals, 9 were redirected to the ED, and the remainder were managed via outpatient pathways or consultant advice. Despite effective triage decisions, only 40% (18/45) of calls were documented formally, raising concerns about clinical governance. Good practices included real-time data collection, high primary care engagement, and categorisation of diverse call outcomes. Conclusions This audit demonstrates effective consultant triage and strong engagement with primary care but identifies a significant gap in call documentation. Recommendations include implementing mandatory documentation, standardising referral protocols, reducing informal contact routes, and disseminating clear ASACU referral criteria. A follow-up re-audit is planned to assess the impact of these changes and ensure sustained improvement.