Chairport - a same day discharge innovation permitting high flow during times of bed occupancy pressures
Papworth E1, Jefferies E1, McFarlane J1, Phull J1 1Royal United Hospital Bath NHS Foundation Trust, United Kingdom
Introduction: Discharging elective post-operative patients on the same day can be clinically safe and improve flow through hospital. Routine length of stay may be an index of high quality care reflected by GIRFT. Within our organisation we have introduced Chairport – a mechanism of same day discharge based on co-morbidity, social circumstances and procedure, with criteria-based nurse delivered discharge from the 9 chair unit that cannot be used for inpatient or acute admissions. Material and Methods: Chairport is run by a Registered Nurse and a Nursing Auxiliary. A prospective review of Chairport utilisation was undertaken between 2017-19. We have evaluated patient acceptability and identified which cases have been best suited to this novel mechanism. Patient experience feedback was also collected.
Results: Prospective data were collected over a 22 month period. 1042 patients underwent Urological surgery and were recovered and discharged from the Chairport. The procedures included 334 transperineal biopsies, 141 circumcisions, 88 ureteroscopies, as well as most cystoscopic and peno-scrotal operations. The age range was 16-93. 35% of all Urological cases are now discharged via Chairport rather than a day-case bed. 92.7% of patients were ASA 1 or 2. Feedback from both patients and their relatives has been universally excellent.
Conclusion: Chairport is a popular and viable mechanism of same-day discharge for the majority of day-case procedures. It does not impact on bed-occupancy, permitting continued elective surgical care even at times of high bed-occupancy due to non-elective admissions. We recommend this mechanism for consideration and adoption.
Chairport - a same day discharge innovation permitting high flow during times of bed occupancy pressures
Papworth E1, Jefferies E1, McFarlane J1, Phull J1 1Royal United Hospital Bath NHS Foundation Trust, United Kingdom
Introduction: Discharging elective post-operative patients on the same day can be clinically safe and improve flow through hospital. Routine length of stay may be an index of high quality care reflected by GIRFT. Within our organisation we have introduced Chairport – a mechanism of same day discharge based on co-morbidity, social circumstances and procedure, with criteria-based nurse delivered discharge from the 9 chair unit that cannot be used for inpatient or acute admissions. Material and Methods: Chairport is run by a Registered Nurse and a Nursing Auxiliary. A prospective review of Chairport utilisation was undertaken between 2017-19. We have evaluated patient acceptability and identified which cases have been best suited to this novel mechanism. Patient experience feedback was also collected.
Results: Prospective data were collected over a 22 month period. 1042 patients underwent Urological surgery and were recovered and discharged from the Chairport. The procedures included 334 transperineal biopsies, 141 circumcisions, 88 ureteroscopies, as well as most cystoscopic and peno-scrotal operations. The age range was 16-93. 35% of all Urological cases are now discharged via Chairport rather than a day-case bed. 92.7% of patients were ASA 1 or 2. Feedback from both patients and their relatives has been universally excellent.
Conclusion: Chairport is a popular and viable mechanism of same-day discharge for the majority of day-case procedures. It does not impact on bed-occupancy, permitting continued elective surgical care even at times of high bed-occupancy due to non-elective admissions. We recommend this mechanism for consideration and adoption.
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