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Decreasing delays in urgent and expedited surgery in a university teaching hospital through audit and communication between peri‐operative and surgical directorates
Author(s) -
Cosgrove J. F.,
Gaughan M.,
Snowden C. P.,
Lees T.
Publication year - 2008
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2008.05441.x
Subject(s) - medicine , audit , seniority , emergency medicine , christian ministry , incidence (geometry) , medical emergency , general surgery , surgery , philosophy , physics , theology , management , optics , political science , law , economics
Summary National Confidential Enquiry into Patient Outcome and Death guidelines for urgent surgery recommend a fully staffed emergency operating theatre and restriction of ‘after‐midnight’ operating to immediate life‐, limb‐ or organ‐threatening conditions. Audit performed in our institution demonstrated significant decreases in waiting times for urgent surgery and an increased seniority of medical care associated with overnight pre‐operative assessment of patients by anaesthetic trainees. Nevertheless, urgent cases continued to be delayed unnecessarily. A classification of delays was developed from existing guidelines and their incidence was audited. The results were disseminated to involved directorates. A repeat of the audit demonstrated a significant decrease in delays (p = 0.001), a significant increase in the availability of surgeons (p = 0.001) and a significant decrease in the median waiting time for urgent surgery compared to the first audit cycle and a previous standard (p < 0.01). We conclude that auditing delays and disseminating the results of the audit significantly decreases delays and median waiting times for urgent surgery because of improved surgical availability.