Same Day Surgical cases which require full operating suite facilities need organizational support for admission and
discharge on same day in order to ensure minimum waiting time and maximum postoperative in hospital care time to
enable safe discharge home the same day. For organizational effi
ciency an important indicator of performance is fi
rst case start
time tardiness. Frequent delays have been observed on several lists with a mixed category of patients which could not start
time due to late arrival of the fi
rst day case and subsequent overrunning of scheduled list time. It also caused inconveniently
delayed discharge time for the last patient.
In order to identify the areas of patient care pathway where signifi
cant delay is occurring we decided to audit the time between
registration of fi
rst scheduled patient and this patient�s arrival in the designated OR, by recording the time of registration, time
of arrival in waiting room of OR suite and time of arrival in the designated OR. We included 112 fi
rst on list cases during a two
month period. Out of these 43 were paediatric patients between 1.5 to 15 years of age.
We found that the average time between registration and arrival in waiting room of OR suite was 45 mins, average time from
waiting room to wheeling into designated OR was 35.60 minutes and total average time from registration to OR was 80.80
minutes (Table 1). For paediatric patients registration to OR time was 75.62 minutes (Table 2). With prolonged waiting times
paediatric patients fasting, apprehension and parents anxiety are major management issues. Our data show that we need to
review our patient care processes in the surgical day case admission and preparation unit, as well as in the OR, to reduce fi
on list day case patients time from registration to OR to 25- 45 minutes, to meet moderate to high performance indicators.
Dr Fauzia Minai is an Assistant Professor of Anaesthesia at the Aga Khan University Karachi. She is Coordinator of Surgical D ay Care services since 2006 and has a special interest in Quality improvement in patient care and organisational processes. She has performed s everal audits which have been published in indexed journals.
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