140 Overall Impact of Varying Plastic Surgery LA Trauma Theatre Availability on Service Delivery in a Medium-Sized Plastic Surgery Department – a Single Centre Multi-Cycle Review

Abstract

Abstract Aim Access to a dedicated local anaesthetic (LA) trauma facility outside standard theatres is a useful tool in the management of surgical trauma. An efficient cost-effective service should provide a see and treat delivery, wherever possible. We analysed the impact of altering service availability on the time between referral and surgical intervention, the time between surgical review and surgical intervention, and overall hospital services. We used this information to establish a pragmatic benchmark for service delivery. Method Between 2020 and 2023, key data was analysed for 5 separate cycles with differing levels of dedicated LA outpatient trauma theatre availability: 100%, 50%, 40%, 37%, 30%. 100% capacity represented two-sessions per day that ran Monday-Friday. Results Falling below 40% capacity caused a significant increase in the proportion of LA plastic surgery cases being performed in CEPOD or other theatres. 100% and 50% capacity saw similar distribution of theatre location. Once LA theatre capacity falls below 50%, this results in a significant delay between referral and day of surgery and a significant delay between senior review and day of surgery. Conclusions Demonstrates that dedicated LA trauma theatre availability of one half-day session daily can be a reasonable and pragmatic level of service provision for similar departments. Lower availability results in disruption to services, including higher main theatres utilisation, greater hospital bed expenditure, and increasing rates delay/cancellation. Increases towards 100% availability have little significant benefit. While this benchmark is specific to the caseload of the single unit, the analysis methods offer a replicable strategy for similar services.