Daycase trauma list: a safe and cost-effective service delivery

Author:

Athar MS1,Fazal MA2,Ashwood N1,Arealis G3,Buchanan D4,Okoth FH5

Affiliation:

1. Department of Trauma and Orthopaedics, Burton Hospital NHS Foundation Trust, Burton Upon Trent, UK

2. Department of Trauma and Orthopaedics, Royal Free Hospitals London NHS Foundation Trust, London, UK

3. East Kent University Hospital NHS Foundation Trust, Queen Elizabeth The Queen Mother Hospital, Margate, UK

4. University Hospital of Wales, Cardiff, UK

5. Royal Wolverhampton NHS Trust, New Cross Hospital, Wolverhampton, UK

Abstract

Introduction Daycase trauma surgery is an evolving and a novel approach. The aim of our study was to report our experience of daycase trauma surgery with a focus on safety, patient experience, complications and limitations. Material and methods Patients scheduled and operated on a daycase trauma list from January 2013 to December 2016 were included in the study. Age, sex, case mix, readmissions within 48 hours, complications, patient satisfaction, reasons for overnight stay and cost effectiveness were evaluated. Results A total of 229 procedures were carried out. The mean age of the patients was 44.3 years (range 16–85 years) . There were 128 men and 101 women, 178 upper-limb and 51 lower-limb cases. Only 2.6% of the patients had stayed overnight for pain control, physiotherapy and neurological observations; 94.5% of the patients were satisfied. The mean visual analogue scale score for satisfaction was 8.7. There were no admissions within 48 hours of discharge and one complication with failure of ankle fixation. The estimated cost saving was £65,562. Conclusion We conclude that a daycase trauma service is safe, cost effective, and yields high patient satisfaction. It reduces the burden on hospital beds and a wide range of upper- and lower-limb cases can be performed as daycase trauma surgery with adequate planning and teamwork.

Publisher

Royal College of Surgeons of England

Subject

General Medicine,Surgery

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