Day of surgery admission for the elective surgical in-patient: successful implementation of the Elective Surgery Programme.
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Department of Surgery, Mayo General Hospital, Castlebar, County Mayo, Ireland, lizconcannon@gmail.com.Issue Date
2012-09-11
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Day of surgery admission for the elective surgical in-patient: successful implementation of the Elective Surgery Programme. 2012: Ir J Med SciPublisher
SpringerJournal
Irish journal of medical scienceDOI
10.1007/s11845-012-0850-5PubMed ID
22965814Additional Links
http://www.springerlink.comAbstract
BACKGROUND AND AIMS: The aim of this prospective cross-sectional study was to determine the impact of (1) ring fencing in-patient general surgical beds and (2) introducing a pre-operative assessment clinic (PAC) on the day of surgery admission (DOSA) rate in a single Irish institution. The secondary aim was to analyse the impact of an increased rate of DOSA on cost efficiency and patient satisfaction. METHODS: An 18-month period was examined following ring-fencing of elective and emergency surgical beds. A PAC was established during the study period. Prospectively collected data pertaining to all surgical admissions were retrieved using patient administration system software (Powerterm Pro, Eircom Software) and a database of performance information from Irish Public Health Services (HealthStat). RESULTS: Ring-fencing and PAC establishment was associated with a significant increase in the overall DOSA rate from 56 to 85 %, surpassing the national target rate of DOSA (75 %). Data relating specifically to general surgery admissions mirrored this increase in DOSA rate from a median of 5 patients per month, before the advent of ring-fencing and PAC, to 42 patients per month (p < 0.0387). 100 patient surveys demonstrated high levels of satisfaction with DOSA, with a preference compared to admission one night pre-operatively. Cost analysis demonstrated overall savings of 340,370 Euro from this change in practice. CONCLUSION: The present study supports the practice of DOSA through the introduction of ring-fenced surgical beds and PAC. This has been shown to improve hospital resource utilisation and streamline surgical service provision in these economically challenging times.Item Type
ArticleLanguage
enISSN
1863-4362Sponsors
The final publication is available at www.springerlink.comae974a485f413a2113503eed53cd6c53
10.1007/s11845-012-0850-5
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