DAY CASE SURGERY
Some patients may be seated in a chair next to the device. Once admitted, assessed and changed into their theatre gown, most patients will walk to the anaesthetic room or operating theatre and board the device there (with exceptions being those who may have received a local anaesthetic prior to transfer). When the surgery has been completed, the patient is transferred into recovery on the device, then back to the day ward or discharge lounge. Then, when recovered sufficiently, discharge takes place, and they can dismount by themselves. The device can then be cleaned, disinfected and returned to the pathway cycle for the next patient. This practice is generally applied whether the day unit / department is self-contained, and its operating theatres are only a short distance away or the transfer to the operating theatre involves a lengthier journey along corridors.
Conclusion Ultimately, eliminating separate, traditional hospital beds for recovery reduces the risk of day surgery beds being ‘reappropriated’ for inpatients, which can have a significant impact on the operation of day case surgery units. Furthermore, a ‘one device’ approach subtly changes the mindset of both patients and staff – it becomes about ambulation of the patient and quick recovery, not about prolonged stay and being ‘unwell’ in a hospital bed. This change in mindset helps contribute towards the successful management and ring-fencing of day surgery units, which is important for improving outcomes, tackling the surgery backlog and reducing costs for the NHS.
A one-device approach in the UK was first explored during the early 1990s and a prototype developed by Anetic Aid in collaboration with the day surgery unit at King’s College Hospital, London – and actually named the KCH Day Surgery Trolley. Since then, these devices have advanced at pace and increased in uptake, alongside the expansion of day surgery procedures. In the UK alone, in excess of 2,500 devices are employed on a one-device approach basis within more than 110 same- day surgery departments. If the number of
devices is multiplied by the annual frequency of use, the number of one-device approach procedures is extremely high – estimated to be as many as one to three million procedures a year. This clearly demonstrates that the approach is proven, successful and reliable.
CSJ
References 1 International Association of Ambulatory Surgery (IAAS) - Day Surgery Development and Practice (2006)
2 C.R. Bailey, M. Ahuja, K. Bartholomew, S. Bew, L. Forbes, A. Lipp, J. Montgomery, K. Russon, O. Potparic and M. Stoker – Guidelines for day-case surgery (2019)
3 British Association of Day Surgery (BADS) / Getting it right first time (GIRFT) / Centre for Perioperative Care (CPF) – National Day Surgery Delivery Pack (2020)
4 Tyler A. Gonzalez, MD, MBA, Spencer J. Stanbury, MD, Ariana N. Mora, BA, W. Emerson Floyd IV, BA, Philip E. Blazar, MD, Brandon E. Earp, MD - The Effect of Stretcher-Based Hand Tables on Operating Room Efficiency at an Outpatient Surgery Center, The Orthopaedic Journal at Harvard Medical School (2017)
The challenge to reduce operation waiting times, even to pre-pandemic levels, cannot be underestimated, and the adoption of more same-day surgery is already being explored as part of the solution. Using one device for transport, treatment and recovery eliminates the need for transfers, offering time efficiencies and therefore helps to increase list capacity.
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WWW.CLINICALSERVICESJOURNAL.COM About the author
Mark Lee joined Anetic Aid in 1992, where he has held a number of roles including running the company’s service department, training and managing its UK-wide team of field engineers responsible for repairing and maintaining patient transport stretchers, surgery trolleys, tourniquets and other specialist equipment.
As well as providing technical support for all products, his current role of product manager involves liaising with clients, gathering feedback and working with Anetic Aid’s in-house design, manufacturing and operations teams to refine and improve the company’s 10,000 item portfolio of equipment, as well as leading the design and development process for new models and innovations.
AUGUST 2021
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