WTP7.11 CEPOD Booking Audit in General Surgery

Abstract

Abstract Introduction and Objectives Repeated internal audits suggested 20% of patients booked into the emergency general surgery theatre list failed to achieve their allotted time to theatre. We wished to investigate this further, identify potential reasons and whether any delay resulted in patient harm. Materials and Methods We retrospectively reviewed 748 consecutive adult patients over a 12 month period booked for appendicectomy, hernia repair, laparoscopic cholecystectomy or abscess I+D. We excluded laparotomies and patients under 18yoa. We recorded pre-operative CEPOD classification, adherence to the timeframe and reasons for delays. Outcome measures included post-op length of stay (POLOS), prolonged hospital stay, and unexpected intraoperative findings. Results Of 748 emergency procedures, 632 (85%) achieved the desired time frame and 116 (15%) were delayed. Of the 116 delayed cases, 94 (81%) were appropriately booked (clinical review). Most delays were caused by a higher priority emergency but in one third of delays no reason was recorded. There was no difference in mean POLOS or unexpected findings between the two groups of those achieving expected time to theatre and those delayed. Conclusions Despite our initial concerns regarding delays to theatre this only occurred in 15% of the study group with no discernible difference in outcomes as measured. The repeated clinical review of potentially delayed emergency patients accessing the operating theatre appears to be safe. Improved documentation for delays and accurate pre-operative bookings across all surgical teams will aid running and assessing the emergency provision.