Audit of trauma case load suitable for a day surgery trauma list and cost analysis

Abstract

Background: Day surgery trauma lists are becoming an increasingly popular and widespread approach to address the inpatient trauma demand on NHS services. A 'Rapid Access' list initiative was set-up to book patients from an emergency pathway who require surgery and also fulfilled the standard day case patient criteria but for whom it was safe to wait for over 24 h before going to theatre.

Materials & methods: We performed a prospective audit of the cases undertaken on the day surgery trauma list over a 12-month period and analysed the number of cases, spectrum of procedures, complications and the cost benefits.

Results: A total of 119 day surgery trauma cases were performed (42 lists; average of 3 cases per list; upper limb procedures accounted for 60%.). The overall cost benefit for day surgery was calculated as the difference between the tariff and the costs for day surgery and inpatient procedures. A cost benefit of £617 per case for day surgery over inpatient surgery was noted with a total saving of £67,450 for the performed procedures.

Discussion: We demonstrate day trauma surgery to be a safe and cost effective method of optimising the management of the appropriate trauma case workload. Further it reduces demand for inpatient beds, provides significant cost savings for the trust and improves patient satisfaction.