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    Day of surgery admission for the elective surgical in-patient: successful implementation of the Elective Surgery Programme.

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    Authors
    Concannon, E S
    Hogan, A M
    Flood, L
    Khan, W
    Waldron, R
    Barry, K
    Affiliation
    Department of Surgery, Mayo General Hospital, Castlebar, County Mayo, Ireland, lizconcannon@gmail.com.
    Issue Date
    2012-09-11
    
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    Citation
    Day of surgery admission for the elective surgical in-patient: successful implementation of the Elective Surgery Programme. 2012: Ir J Med Sci
    Publisher
    Springer
    Journal
    Irish journal of medical science
    URI
    http://hdl.handle.net/10147/248091
    DOI
    10.1007/s11845-012-0850-5
    PubMed ID
    22965814
    Additional Links
    http://www.springerlink.com
    Abstract
    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
    Article
    Language
    en
    ISSN
    1863-4362
    Sponsors
    The final publication is available at www.springerlink.com
    ae974a485f413a2113503eed53cd6c53
    10.1007/s11845-012-0850-5
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    Mayo General Hospital

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