Anika Schwarze-Chintapatla
Introduction
Day case surgery is recognised as the preferred pathway for many elective surgical procedures, offering clinical benefits of reduced hospital time as well as system benefits of more effective use of healthcare resources. Day cases should be considered the default pathway for most surgical procedures, and national guidelines recommend achieving high day case rates where clinically appropriate. However, optimal day case rates are not always achieved. Here, we audit the surgical day case rates in the Oxford University Hospitals Urology department and investigate the reasons for which optimal day case rates are not achieved.
Methods
We completed a retrospective electronic medical record review of urological day cases performed in October 2024. We evaluated the rates of day cases compared to the British Association of Day Surgery (BADS) targets. Where planned day cases were admitted overnight, we reviewed the patient records to identify the reasons and context for admission.
Results
Of 88 planned day cases in October 2024, 13 cases were admitted. Of these 7 were considered avoidable admissions. Reasons for such admissions included transport, social, chronic pain, and late start resulting in an overnight trial of void.
Conclusions
This audit demonstrated an overall high day case success rate, however 53.8% of unplanned admissions were considered avoidable. These findings highlight opportunities to improve pre-operative planning and patient selection to reduce avoidable surgical admissions.
Authors
Tishan Wellalagodage, Oxford University Hospitals Trust and Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, United Kingdom
Anika Schwarze-Chintapatla, University of Oxford, Oxford, United Kingdom
Soumitra Ghosh, Nuffield Department of Anaesthesia, Oxford University Hospitals NHS Trust, Oxford, United Kingdom