Introduction
Unplanned admission (UA) following day case surgery can negatively impact the healthcare system and patients [1]. The UA rate can therefore be used to evaluate the quality of a day surgery pathway, with a low rate indicating better outcomes [2].
Methods
This audit accounted for all NHS day case procedures at the Freeman Day Treatment Centre (DTC) from 1st October 2022 to 30th September 2023 (Year 1) and 1st October 2023 to 30th September 2024 (Year 2). We compared the UA rate for each procedure to targets outlined by the Royal College of Anaesthetists [1], based on the British Association of Day Surgery recommended day case rates [3].
Results
In Year 1, 5033 cases were completed, of which 60 (1.19%) required admission. Two procedures had UA rates that exceeded the targets: laparoscopic cholecystectomy (<5% target, 9% actual) and lumbar spine decompression (<10% target, 14% actual). In Year 2, 6458 cases were completed, of which 71 (1.10%) required admission. Only laparoscopic cholecystectomy had a UA rate that exceeded the target (<5% target, 14% actual).
Conclusions
The Freeman DTC has a low overall UA rate, akin to some of the best-performing units in the UK [4]. However, the laparoscopic cholecystectomy UA rate has persistently exceeded the target, so further work is being conducted to identify how it can be improved.
Authors
Krishan Nandapalan
Newcastle University, Newcastle upon Tyne, United Kingdom
Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom