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Outofhours operating failure to close the audit cycle

Outofhours operating failure to close the audit cycle A prospective study of all outofhours operations performed in a district general hospital was undertaken over two periods. During the first period 1 month facilities for emergency operating were reviewed and it was concluded that outofhours operating should be reduced and several tactics to improve the situation were agreed. A reaudit was undertaken over 4 months second period and results of the two periods compared. Orthopaedic cases performed outofhours in both periods of study were 38 vs 40. Mean theatre delay for general surgical cases in both periods was 5 h 30 min vs 5 h 21 min and theatre usage after midnight during weekdays showed no significant difference 23 vs 28. 50 of operations performed after midnight in both periods could possibly have been avoided. The attempt to reduce outofhours operating failed because there was no protocol. In order to reduce inappropriate operating after midnight, a dedicated daytime emergency theatre is necessary in addition to an increase in the number of daytime orthopaedic trauma lists. Failure to close the audit cycle loop suggests that a more determined effort is required to reduce unsupervised emergency surgery and unnecessary sleep deprivation. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Clinical Effectiveness Emerald Publishing

Outofhours operating failure to close the audit cycle

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Publisher
Emerald Publishing
Copyright
Copyright © Emerald Group Publishing Limited
ISSN
1361-5874
DOI
10.1108/eb020869
Publisher site
See Article on Publisher Site

Abstract

A prospective study of all outofhours operations performed in a district general hospital was undertaken over two periods. During the first period 1 month facilities for emergency operating were reviewed and it was concluded that outofhours operating should be reduced and several tactics to improve the situation were agreed. A reaudit was undertaken over 4 months second period and results of the two periods compared. Orthopaedic cases performed outofhours in both periods of study were 38 vs 40. Mean theatre delay for general surgical cases in both periods was 5 h 30 min vs 5 h 21 min and theatre usage after midnight during weekdays showed no significant difference 23 vs 28. 50 of operations performed after midnight in both periods could possibly have been avoided. The attempt to reduce outofhours operating failed because there was no protocol. In order to reduce inappropriate operating after midnight, a dedicated daytime emergency theatre is necessary in addition to an increase in the number of daytime orthopaedic trauma lists. Failure to close the audit cycle loop suggests that a more determined effort is required to reduce unsupervised emergency surgery and unnecessary sleep deprivation.

Journal

Journal of Clinical EffectivenessEmerald Publishing

Published: Mar 1, 1997

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