Asem Abdelrahman
Introduction
- Ureteroscopy (URS) is typically a day-case procedure, with same-day discharge as the standard.
- Delayed discharge (>23 hours) impacts hospital efficiency and patient flow.
- This audit examines reasons for delayed discharge and post-operative sepsis incidence after elective URS.
- Using GIRFT (Getting It Right First Time) and BADS (British Association of Day Surgery) data, we compared our same-day discharge rates against national benchmarks.
- Nationally, 75% of URS patients are discharged same-day, while 25% require an overnight stay (BADS).
Methods
- Retrospective review of 92 elective URS patients (June 2023–September 2024).
- Factors influencing delayed discharge were analyzed, including patient demographics, operative details, and post-operative sepsis risk.
- Data collected:
- Patient demographics
- Operative details
- Length of stay
- Post-operative sepsis occurrence
- Results were compared to BADS and GIRFT benchmarks.
Results
- Same-day discharges: 65 patients (70.65%)
- Stayed >23 hours: 28 patients (30.4%)
- Discharged next day: 17%
Causes of Delayed Discharge
- IV antibiotics (8 patients)
- Observation/monitoring (6)
- Social reasons (4)
- Awaiting specialty input (4)
- Acute urinary retention (3)
- Pain (2)
- Hypotension (1)
Conclusion
- The results indicate 70.65% same-day discharge rate is slightly below the BADS benchmark (75%), highlighting room for improvement.
- IV antibiotics and post-op observation were the main delay factors.
- Protocol adjustments, perioperative planning, and risk stratification may enhance efficiency.
- Optimizing pain management and specialty input could further improve discharge rates while maintaining safety.
Authors
Asem Abdelrahman
Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
Kasra Saeb-Parsy
Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom