WTP4.2 Reasons for delays in Emergency General surgery services at Night

Abstract

Abstract Introduction There are at least 33000 Emergency General Surgery (EGS) cases in the UK annually, with 80-90% of all deaths in general surgery noted in patients undergoing EGS. Delays in undergoing EGS are associated with increased patient morbidity, mortality and increased length of stay. We conducted a study to investigate reasons behind delays in emergency general surgery patients undergoing surgery during the night shift. Methodology Prospective data was collected on all surgical activity in the Emergency theatre after 20:00 hours between 26th February 2022 and 16th April 2022 (50 days). Data was collected from paper medical records. Results 338 patients were booked to undergo surgery during the night shift over the specified time period. 68% (n=230) of cases scheduled for overnight operating had been booked during the day shift (08:00-20:00) whilst 32% (n=108) were booked during the night shift (20:00- 08:00). 70% of cases (n= 236) were rescheduled for surgery the following day. 47% of rescheduled cases were postponed due to surgical decision-making however 31% were postponed due to unavailability of theatre space (Other surgical specialties utilising theatre). All other postponements (22%) were due to anaesthetic team unavailability. Conclusion Our study identifies 3 main reasons for reduced emergency theatre utilisation in the night. Modifiable causes for delay include unavailability of theatre space and anaesthetic team. We recommend dedicated staff and theatre for EGS to improve patient outcomes. We recommend discussion with the on call surgical Consultant prior to postponement for surgical reasons. By improving overnight theatre utilisation, hospital pressures and patient outcomes stand to be improved.