Premium
PR30P
DELIVERY OF ACUTE PLASTIC SURGICAL SERVICES IN A TERTIARY CENTRE
Author(s) -
Usmar S. J.,
She R. W.,
Smith K.
Publication year - 2009
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2009.04927_30.x
Subject(s) - medicine , triage , seniority , plastic surgery , surgery , emergency medicine , medical emergency , general surgery , political science , law
Purpose: To (1) assess the accuracy with which acute plastic surgical caseload is predicted; (2) identify key factors which influence operating times; and (3) determine whether services are delivered in a timely manner. Methodology: Data was collected prospectively for 200 patients presenting acutely to the Auckland Regional Plastic, Reconstructive and Hand Surgery Unit between 26 November and 22 December 2008. Recorded variables included procedure type, predicted and actual theatre time, level of surgeon and anaesthetist experience and triage category. Results: Of the 200 patients enrolled in the study, 9 were excluded due to incomplete data. Average time spent in the operating theatre was 81 minutes. This was over‐estimated on the pre‐operative booking form by 17% (R = 0.65, p < 0.001). The intra‐operative time was significantly longer when the procedure was performed by a consultant surgeon compared to a trainee (mean = 115 min versus 76 min, p < 0.001) or when regional anaesthesia was used (median = 116 min versus 72 min, p = 0.02). Intra‐operative time was not affected by anaesthetist seniority (p = 0.18). The procedure was correctly identified on the pre‐operative booking form in 75% of cases. Only 59% of cases were performed within their allotted triage time. Conclusion: Acute Plastic Surgical Services were not delivered in a timely manner for a significant number of patients. This occurred despite a consistent over‐estimation of theatre time requirements. Methods for improving service efficiency need to be investigated, with a view to reducing the social and economic cost of delays.