naa a22 4500 510740340 CHVBK 20180411083026.0 cr unu---uuuuu 180411e20130301xx s 000 0 eng 10.1007/s11845-012-0850-5 doi (NATIONALLICENCE)springer-10.1007/s11845-012-0850-5 Day of surgery admission for the elective surgical in-patient: successful implementation of the Elective Surgery Programme [Elektronische Daten] [E. Concannon, A. Hogan, L. Flood, W. Khan, R. Waldron, K. Barry] Background and aims: The aim of this prospective cross-sectional study was to determine the impact of (1) ring fencing in-patient general surgical beds and (2) introducing a pre-operative assessment clinic (PAC) on the day of surgery admission (DOSA) rate in a single Irish institution. The secondary aim was to analyse the impact of an increased rate of DOSA on cost efficiency and patient satisfaction. Methods: An 18-month period was examined following ring-fencing of elective and emergency surgical beds. A PAC was established during the study period. Prospectively collected data pertaining to all surgical admissions were retrieved using patient administration system software (Powerterm Pro, Eircom Software) and a database of performance information from Irish Public Health Services (HealthStat). Results: Ring-fencing and PAC establishment was associated with a significant increase in the overall DOSA rate from 56 to 85%, surpassing the national target rate of DOSA (75%). Data relating specifically to general surgery admissions mirrored this increase in DOSA rate from a median of 5 patients per month, before the advent of ring-fencing and PAC, to 42 patients per month (p<0.0387). 100 patient surveys demonstrated high levels of satisfaction with DOSA, with a preference compared to admission one night pre-operatively. Cost analysis demonstrated overall savings of 340,370 Euro from this change in practice. Conclusion: The present study supports the practice of DOSA through the introduction of ring-fenced surgical beds and PAC. This has been shown to improve hospital resource utilisation and streamline surgical service provision in these economically challenging times. Royal Academy of Medicine in Ireland, 2012 Day of surgery admission nationallicence Same day admission nationallicence Ring-fencing nationallicence Pre-operative assessment nationallicence Pre-admission nationallicence Elective surgery nationallicence Concannon E. Department of Surgery, Mayo General Hospital, Castlebar, County Mayo, Ireland aut Hogan A. Department of Surgery, Mayo General Hospital, Castlebar, County Mayo, Ireland aut Flood L. Department of Surgery, Mayo General Hospital, Castlebar, County Mayo, Ireland aut Khan W. Department of Surgery, Mayo General Hospital, Castlebar, County Mayo, Ireland aut Waldron R. Department of Surgery, Mayo General Hospital, Castlebar, County Mayo, Ireland aut Barry K. Department of Surgery, Mayo General Hospital, Castlebar, County Mayo, Ireland aut Irish Journal of Medical Science Springer-Verlag 182/1(2013-03-01), 127-133 0021-1265 182:1<127 2013 182 11845 https://doi.org/10.1007/s11845-012-0850-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s11845-012-0850-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Concannon E. Department of Surgery, Mayo General Hospital, Castlebar, County Mayo, Ireland aut NATIONALLICENCE 700 1- Hogan A. Department of Surgery, Mayo General Hospital, Castlebar, County Mayo, Ireland aut NATIONALLICENCE 700 1- Flood L. Department of Surgery, Mayo General Hospital, Castlebar, County Mayo, Ireland aut NATIONALLICENCE 700 1- Khan W. Department of Surgery, Mayo General Hospital, Castlebar, County Mayo, Ireland aut NATIONALLICENCE 700 1- Waldron R. Department of Surgery, Mayo General Hospital, Castlebar, County Mayo, Ireland aut NATIONALLICENCE 700 1- Barry K. Department of Surgery, Mayo General Hospital, Castlebar, County Mayo, Ireland aut NATIONALLICENCE 773 0- Irish Journal of Medical Science Springer-Verlag 182/1(2013-03-01), 127-133 0021-1265 182:1<127 2013 182 11845 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer