Chinmayi Kattimani
Introduction
TONKIDZ was an initiative in our trust to tackle long patient waiting times, clear unprecedented backlog and address delays in delivering paediatric ENT surgical care in the post-COVID-19 pandemic period. Following its tremendous success, high-volume lists (HVLs) were conducted at regular intervals. We aim to describe our single centre experience of safe and high-quality anaesthetic provision for HVLs elective paediatric ENT day-case surgeries.
Methods
We initially planned dedicated high-volume theatre weeks for paediatric ENT surgeries in July, September and November 2023. Following three successful rounds, we identified areas for improvement, enhanced clinical practices and implemented regular HVLs. We performed a retrospective analysis of highvolume paediatric ENT day-case surgeries from 1st April 2024 to 31st March 2025.
Results
232 children had adenotonsillectomies in overall sixteen days-split over three alternating months averaging 14.5 kids per day in 2023. TONKIDz project enhanced productivity by ten folds on a weekly basis and was 2.76 times more cost-effective. HVLs had 287 children undergo elective ENT day-case surgeries (93.38% adeno-tonsillectomies). More than 70% cases were completed as same day discharges in accordance with the British Association of Day Surgery (BADS) target1. The postoperative complication rate was within the national target levels.
Conclusion
We developed a collaborative approach to enhance same-day discharges which help improve service efficiency as identified by the GIRFT national report for ENT surgery 2. Our experience with HVLs in paediatric ENT day-case surgeries has demonstrated it as a safe and efficient method to help reduce surgical back log with substantial financial impact.
Authors
CHINMAYI KATTIMANI
BARKING,HAVERING AND REDBRIDGE UNIVERSITY HOSPITALS, ROMFORD, United Kingdom
KALYANI GORRELA
BARKING,HAVERING AND REDBRIDGE UNIVERSITY HOSPITALS, ROMFORD, United Kingdom
GAURAV KUMAR
BARKING,HAVERING AND REDBRIDGE UNIVERSITY HOSPITALS, ROMFORD, United Kingdom