News and presentations from today's British Association of Day Surgery conference focusing on Day Case Foot and Ankle Surgery and chaired by Mr David Townshend Consultant Northumbria Healthcare NHS Foundation Trust.
Effect of Covid-19 on foot & ankle surgery
Mr Jitendra Mangwani Consultant Trauma and Foot & Ankle Orthopaedic Surgeon
University Hospitals of Leicester NHS Trust
• Findings of the UK FALCON foot and ankle Covid-19 national audit
• Myths about day case surgery
Optimising your day case pathway
Dr Kim Russon Immediate Past President, British Association of Day Surgery (BADS) Consultant Anaesthetist, Clinical Lead for Day Surgery
The Rotherham NHS Foundation Trust
• Key elements of a day surgery pathway
• Patient suitability for day surgery
• Planning for successful day surgery
Kim gave an overview and tips and advice for successful day case surgery. She said in the UK the definition of day surery is admitted, operated on and going home the same calendar day, this varies as in other countries some include 23 hour stay. Kim said there are benefits of day surgery for both patients and the hospital. She said there are lots of opportunities to improve Day Surgery, keys to success include:
- high quality day surgery pathways
- consistent day surgery message throughout
- support at Trust board level
- appropriate resources
- benchmark, review service and drive change
- important to have champions and key enablers
Dr Kim Russon Biography 0.04 MBDOCXfile
Dr Kim Russon Abstract 0.02 MBDOCXfile
Dr Kim Russon Slides 33.09 MBPPTXfile
Kim said it's important that GPs know what can be done as a day case, there is a directory of over 200 procedures list as a day case over all the specialities. She said it's important to optimise patients for day case, not just because they're next on the waiting list, they need to fit the criteria. This can include surgical procedures lasting 3-4 hours or more, these are routinely performed on a day case basis as long as there is good anaesthesia and analgesia in place, the RCOA supports this. Emergency cases can also be performed as day surgery. A lot of patients prefer day case and elderly patients tend to do better in the home environment. The day surgery unit needs to be set up appropriately this means no inpatients taking beds, dedicated facilities and staff for the entire day surgery pathway. No beds, showers or catering so you have no capacity for accepting inpatients. Kim said; "there should be no pyjamas for patients, so there is no "sick role" they are motivated to recover and leave, we do believe day surgery improves patient outcomes". Short acting general anaesthetic is required for rapid recovery, and good management of pain and nausea. Nurse led discharge works well, checking patients are able to get home safely, telephone follow up the next day, and a 24 hour telephone number to access support. Kim concluded her presentation by saying "for successful day surgery you need a high quality pathway where you treat day surgery as the norm".
Resources: https://rcoa.ac.uk/safety-standards-quality/quality-improvement/raising-standards-rcoa-quality-improvement-compendium
https://www.gettingitrightfirsttime.co.uk/
https://bads.co.uk/
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