Aims To compare the trust-wide performance with the standard by the British Association of Day Surgery in the management of cholecystectomy Methods 4 months of Electronic data of patients undergoing elective laparoscopic cholecystectomy in 2020 was analyzed. Those who had emergency cholecystectomy were excluded. Results 112 of 145 total patients were female and 33 were male. The age range was 18–82 Around 65% of patients were sent home the same day. 51 Patients ended up being admitted. 33 of these were Pre-booked as inpatients' intent. 39% (13/33) had no specific reason for being booked as an inpatient. The rest Majority had medical issues quoted as the reason for booking.35% (18) of the 51 admitted patients were actually brought in as day-case lap-chole. 6 of these were admitted for perioperative surgical issues and 8 had no documented reason. The Mean length of stay was 2.56 days(0–13). Our Performance was noted to be 10% lower than the BADS standard. Conclusion Relatively more patients are being treated as inpatients than the recommended standard. About 1/4th of those who were inpatient had no specific/genuine grounds to be kept in. There is a need for improvement in pre and perioperative documentation to explain the reason for inpatient management. Development of inpatient surgery booking criteria and adherence to set criteria.

Aims To compare the trust-wide performance with the standard by the British Association of Day Surgery in the management of inguinal hernias. Methods Electronic data of patients who underwent Inguinal Hernia Repairs in the trust from September 2019 to December 2019 was analyzed. Results A total of 122 male and 11 female patients had hernias repaired in this time period.18 were emergency while the rest of the cases were elective. The ages ranged from 19–91 with a mean age of 62. Of the 115 electives, 60% were performed as day-case. The mean length of stay was 1.7days (R 0–12).34 out of 46 (74%) patients who stayed inpatient were actually booked as day-case. 73% had no documented reason for their admission.4 patients were admitted for medical reasons 2 for post-operative surgical complications. Of patients pre-booked as inpatients,10 were quoted to have serious medical issues while 5 had no clear reason. The vast majority had open repairs while 26% of the 115 patients had laparoscopic repairs. Conclusion Our Performance was noted to be 30% lower than the BADS standard. There is a need of: Development of inpatient surgery booking criteria and adherence. Discussion with anesthetic colleagues to assist drive towards day-case surgery. Clear documentation in the clinical letters to explain the reason for inpatient management and booking. Perioperative notes need improvement.