1074 Surgical care closer to home: is it up to the mark?
Published Date: 17th August 2022
Publication Authors: Maddipati T, Chilukuri L, Abdelaziz M
Aims
Paediatric surgery is challenging and training in this area is subspecialised including anaesthesia and post operative care. The Royal College of Surgeons Standards of Surgical care for Children, 2013 supports the ‘provision of care closer to home’ in patients with access to appropriate level of care. Typically this is district general hospital (DGH) care in healthy patients over 4 years old. This was a significant change in practice from specialised tertiary centre to local district hospitals when safe. This is coordinated through an effective Clinical Network. This audit project sought to evaluate the safety and outcomes paediatric surgical services offered at a representative DGH.
Methods
A retrospective review of randomly selected 226 (out 950 cases) health records of paediatric patients who had surgery at Whiston DGH in 2017. This data was collected from electronic records, analysed in the Quality Improvement- Clinical Audit department and evaluated with respect to urgency, type of surgery, outcome, adverse events, accessibility, length of stay and patient satisfaction.
Results
56% of the procedures were performed on males (126). The mean age of the patients was 11. The highest proportion of surgeries were undertaken in ENT (32%), followed by Orthopaedics (23%), Plastic Surgery (22%), General Surgery (13%), Urology (7%), Ophthalmology (3%), and Gynaecology (1%). Out of the 226 procedures, 74% were Elective and 26% were undertaken as Emergencies. There were no deaths or post operative admissions to high dependency unit. Length of stay was prolonged in some cases. There were no complaints in any of the cases.
Conclusion
A significant number of elective and emergency paediatric surgeries from a variety of subspecialities were performed in Whiston hospital in 2017. This audit suggests positive outcomes and good patient satisfaction. We believe that a significant number of paediatric surgeries could be performed in DGHs safely, while referring specialised procedures to tertiary centre, which would increase their capacity in a collaborative network.
McGalliard, R; Maddipati, T; Chilukuri, L; Abdelaziz, M. (2022). 1074 Surgical care closer to home: is it up to the mark?. Archives of Disease in Childhood. 107(Suppl 2), p.A471. [Online]. Available at: https://adc.bmj.com/content/107/Suppl_2/A471.1 [Accessed 22 December 2022].
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