Maximising efficiency in plastic surgery local anaesthetic lists

Marlborough, Fergal; Anderson, ID; Allison, Keith

doi:10.1016/j.bjps.2020.05.096

Cited by 1 publication

(4 citation statements)

References 3 publications

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“…Four published papers reporting similar service delivery models for patients requiring plastic surgery under LA were identified. One described a same-day, elective plastic surgery service model 6. The other three were retrospective audits of same-day surgery,7–10 one of which was at national level7 and one spanned a 10-year period 8.…”

Section: Introductionmentioning

confidence: 99%

“…The other three were retrospective audits of same-day surgery,7–10 one of which was at national level7 and one spanned a 10-year period 8. Therefore, although limited, available evidence indicated a See and Treat service had the potential to improve patient safety, particularly as fewer staff are needed to deliver prompt, efficient and safe care 6–9. Any service reconfiguration must also consider the possibility of inadvertently introducing new safety risks; increased infection rates are particularly relevant for surgical services like this.…”

Section: Introductionmentioning

confidence: 99%

“…8 Therefore, although limited, available evidence indicated a See and Treat service had the potential to improve patient safety, particularly as fewer staff are needed to deliver prompt, efficient and safe care. [6][7][8][9] Any service reconfiguration must also consider the possibility of inadvertently introducing new safety risks; increased infection rates are particularly relevant for surgical services like this. However, a systematic review indicated that some types of hand surgery could be performed in a non-operating theatre setting without increasing the risk of infection.…”

Section: Introductionmentioning

confidence: 99%

“…One described a same-day, elective plastic surgery service model. 6 The other three were retrospective audits of same-day surgery, 7–10 one of which was at national level 7 and one spanned a 10-year period. 8 Therefore, although limited, available evidence indicated a See and Treat service had the potential to improve patient safety, particularly as fewer staff are needed to deliver prompt, efficient and safe care.…”

Section: Introductionmentioning

confidence: 99%

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Nurse-led sustainable plastic surgery trauma service transformation: a positive COVID-19 legacy

Flanagan,

Janes

2023

BMJ Open Qual

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The aim of this quality improvement was to develop a sustainable nurse-led ‘See and Treat’ service in a regional plastic surgery unit in England for patients requiring plastic surgery under local anaesthetic following traumatic injury.Trauma-related injuries are a substantial part of the workload in the plastic surgery department in question; with people with the most minor injuries requiring surgery under local anaesthetic accounting for 17%. COVID-19 threatened the continuation of any minor surgery service, but the initial crisis-driven response to the pandemic provided the opportunity to develop a new, more effective, nurse-led service for this patient group.The Model for Improvement was used and four ‘Plan, Do, Study, Act’ cycles deployed over an 8-week period, involving 102 patients. Routine quantitative and qualitative data in the form of a semistructured patient feedback proforma were used to guide the improvement process, optimising the new service design and delivery.The results demonstrated that 98% (n=100) of patients received same-day surgery via the new ‘See and Treat’ service. Staff and patient satisfaction remained high throughout; all patients preferred same-day surgery. No negative unintended consequences, for example, postoperative infections, were identified. One positive unintended consequence was the reduction in carbon footprint achieved by decreasing clinical waste and patient travel.Improvement methodology was successfully used by a nurse-led team to enable the continuation and enhancement of surgical services for trauma patients during COVID-19-driven service disruption. This service transformation has resulted in the retention of the revised service delivery model as the ‘new normal’ approximately 2 years later. The COVID-19 pandemic challenged the resilience of the trauma surgery service but led to a positive long-term legacy that sustainably improved waiting times and patient experience while maintaining safety.

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