Louise Murray
Introduction
PFR and VH have been identified by BADS and GIRFT as target day case gynaecological procedures, with suggested day case rates of 85% and 60% respectively. A PFR/VH day case pathway was introduced at TRFT in October 2023; we undertook a service evaluation from October 2023-December 2024.
Methods
Data on electronic theatre and patient record systems were reviewed for all elective PFR/VH procedures in the evaluation period, including identifying any readmissions within the first post-operative week. Planned day cases also had an audit form completed (50% completion rate) including a call on day 1 post-op.
Results
The total number of elective PFRs/VHs performed during the evaluation period was 205; 44 of these were day cases. In a 2019 audit, all such procedures had inpatient stays. Overall day case rates for all procedures were up to 40%, with highest rates for PFR. Reassuringly, only 1 patient was readmitted within the first week (readmission rate 2%), and discharged 2 days later with conservative management. Post-operative urinary retention was an issue, with 6 patients (4 PFR/2 VH) re-presenting as outpatients within a week. All patients completing the post-op call were happy with day case management.
Conclusions
Day case PFR and VH can be safely and effectively introduced on morning lists at a DGH. We expect further increases in day case rates as we have expanded the criteria and procedures are also being done on afternoon lists, but we need to work with the surgeons to address post-operative urinary retention.
Authors
Louise Murray
Rotherham Hospital, Rotherham, United Kingdom
Kim Russon
Rotherham Hospital, Rotherham, United Kingdom