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ENT day surgery in England and Wales – an audit by the Royal College of Surgeons (Eng.) Comparative Audit Service

Published online by Cambridge University Press:  29 June 2007

Peter M. Brown*
Affiliation:
Comparative Audit Service, Surgical Epidemiology and Audit Unit, Royal College of Surgeons of England, Lincoln's Inn Fields, London, UK.
Sarah Fowler
Affiliation:
Comparative Audit Service, Surgical Epidemiology and Audit Unit, Royal College of Surgeons of England, Lincoln's Inn Fields, London, UK.
Rowena Ryan
Affiliation:
Comparative Audit Service, Surgical Epidemiology and Audit Unit, Royal College of Surgeons of England, Lincoln's Inn Fields, London, UK.
Raymond Rivron
Affiliation:
Comparative Audit Service, Surgical Epidemiology and Audit Unit, Royal College of Surgeons of England, Lincoln's Inn Fields, London, UK.
*
Address for correspondence: Mr P. M. Brown, ENT Department, Milton Keynes General NHS Trust, MK6 5LD.

Abstract

An audit of day surgery was carried out by the Royal College of Surgeons (Eng.) Comparative Audit service. Data from 121 respondents on over 3 962 day cases were analysed from both retrospective information and from prospective individual patient proformas. The day surgery rate is 31 per cent. The variability of facilities for day-surgery, the timing of lists, type of anaesthetic used and case-mix are discussed. Outcome and the reasons for admission to an overnight bed are analysed. The overall admission rate was found to be 2.8 per cent (range 0.6–19.5 per cent between consultants). Seventy per cent of ENT day-surgery was performed on morning lists which have a lower admission rate than afternoon lists. The main reasons for admission are vomiting 30 per cent, haemorrhage 20 per cent and inadequate recovery from anaesthetic 22 per cent. A more detailed analysis of reasons for admission were given for tonsillectomy, adenoidectomy, FESS, and grommets. Recommendations are given which might increase the scope of safe day-surgery and reduce admission rate.

Type
Audit Article
Copyright
Copyright © JLO (1984) Limited 1998

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