Impact of emergency admissions on elective surgical workload

Nasr, Ayman; Reichardt, K.; Fitzgerald, Karen; Arumugusamy, M; Keeling, P.; Walsh, T. N.

doi:10.1007/bf03167926

Cited by 40 publications

(26 citation statements)

References 3 publications

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“…This would be greatly welcomed by women as cancellation of operations is very unsatisfactory and can result in significant distress and anxiety for the women. 15 There is also economic considerations of cancelling operations by failing to adhere to performance targets. The use of 24-hour day case vaginal hysterectomy would allow the procedure to be carried out irrespective of the bed shortages with significant financial savings.…”

Section: Discussionmentioning

confidence: 99%

A prospective observational study of the safety and acceptability of vaginal hysterectomy performed in a 24‐hour day case surgery setting

Penketh

Griffiths

Chawathe

2007

BJOG

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Objective To assess the safety and acceptability of vaginal hysterectomy with and without simultaneous oophorectomy in a 24-hour day case surgery setting for women with nonprolapse indications for surgery.Design Prospective observational study.Setting A busy teaching hospital and tertiary referral centre for Obstetrics and Gynaecology.Population Seventy-one women from one consultant's practice underwent a vaginal hysterectomy with a planned discharge within 24 hours after the procedure. All women had a body mass index less than 40 and a suitable home environment for routine day case surgery, other than that the women were from an unselected population.Method Prospective observational study.Main outcome measures The duration of the operation and mean blood loss were recorded. Any intraoperative complications were noted. In addition, the proportion of women discharged home within 24 hours of the operation was recorded together with any readmissions to hospital. Returns to theatres and any postoperative complications were also recorded. Postoperative pain scores were assessed 6 and 24 hours after procedure in selected women.Results Seventy-one vaginal hysterectomies were performed as 24-hour day case procedures. The intraoperative complication rate was 1.4%. Sixty-five women were discharged home within 24 hours (91.5%). The readmission rate within this group was 6.2%. The duration of the procedure, mean blood loss, return to theatre rate and incidence of febrile illness were comparable with rates recorded in inpatient studies.Conclusions Vaginal hysterectomy performed as a 24-hour day case procedure appears to be as safe as traditional inpatient management, with a high rate of early discharge and a low rate of readmission. This may have additional advantages for the woman and healthcare provider alike.

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Section: Discussionmentioning

confidence: 99%

A prospective observational study of the safety and acceptability of vaginal hysterectomy performed in a 24‐hour day case surgery setting

Penketh

Griffiths

Chawathe

2007

BJOG

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“…It also requires major expenditure of time and cost by patients and their families [1,5,6,22]. Cancellation of an elective procedure carries a major cost implication to the hospitals because of wasted hospital resources and major impact on patients because of loss of time from work as well as the impact of the wasted effort on the patient's family [22].…”

Section: Resultsmentioning

confidence: 99%

“…Cancellations of operation due to inadequate preparation of important medical conditions are avoidable [5][6][7]22] the medical problems could have been identified in time and the number of cancellations on medical grounds could have been avoided by establishing a formal protocol with the surgeons. All the patients are assessed a day before operation by the anesthetist in our hospital and the few available anesthesiologist were not involved in preoperative assessment.…”

Section: Discussionmentioning

confidence: 99%

Prospective Study of Proportions and Causes of Cancellation of Surgical Operations at Jimma University Teaching Hospital, Ethiopia

Haile¹,

Desalegn²

2015

IJAR

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“…They consequently do not have to take additional leave if the operation is performed during a weekend. [15] The Saturday elective operations are not interrupted, as a separate theatre is available for emergencies. In the absence of an emergency theatre during weekdays, performing elective operations on Saturdays remains a reasonable approach in an effort to reduce the elective operation waiting period.…”

Section: Discussionmentioning

confidence: 99%

Safety and affordability of an elective Saturday list at Pietersburg Hospital, Limpopo, South Africa

Bhuiyan

Mavhungu

2018

S Afr Med J

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Background. The backlog of patients waiting for operations continues to be a problem in many public hospitals in South Africa (SA), with elective surgery procedures being postponed for up to 2 years. Objective. To determine the rate of death in hospital or out of hospital within 30 days of an elective procedure performed on a Saturday, and to determine the cost incurred by paying staff members who perform these operations. Method. A prospective, observational descriptive cohort study of all patients undergoing inpatient general surgery operations during weekdays and weekends between 1 September 2015 and 31 August 2016 (1 year) at Pietersburg Hospital (PBH), Limpopo, SA. Microsoft Excel 2010 (Microsoft, USA) was used to analyse and derive descriptive statistics. The finance department at the hospital calculated the overtime pay for theatre staff who operated on Saturdays.Results. The study included 1 352 operations (607 elective and 745 emergency procedures). Saturday elective operations contributed 133/607 (22%), and the rate of death for these operations was 1.5%. The most common procedures performed on a Saturday were hernia repair and amputation. The cost for 8 hours of work on a Saturday was ZAR13 900, amounting to a total of ZAR333 600 for 24 Saturdays. Conclusion. Performing minor surgery on a Saturday had a mortality rate of 1.5%, and a theatre staff cost of ~ZAR2 317 per patient, excluding surgeons' fees. If surgeons were to be paid the costs would be ZAR3 450 per patient.

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Impact of emergency admissions on elective surgical workload

Cited by 40 publications

References 3 publications

A prospective observational study of the safety and acceptability of vaginal hysterectomy performed in a 24‐hour day case surgery setting

A prospective observational study of the safety and acceptability of vaginal hysterectomy performed in a 24‐hour day case surgery setting

Prospective Study of Proportions and Causes of Cancellation of Surgical Operations at Jimma University Teaching Hospital, Ethiopia

Safety and affordability of an elective Saturday list at Pietersburg Hospital, Limpopo, South Africa

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