Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-18T22:35:37.576Z Has data issue: false hasContentIssue false
  • English
  • Français

ENT day surgery in England and Wales – an audit by the Royal College of Surgeons (Eng.) Comparative Audit Service

Published online by Cambridge University Press:  29 June 2007

Peter M. Brown ,
Sarah Fowler ,
Rowena Ryan  and
Raymond Rivron
Peter M. Brown*
Affiliation:
Comparative Audit Service, Surgical Epidemiology and Audit Unit, Royal College of Surgeons of England, Lincoln's Inn Fields, London, UK.
Sarah Fowler
Affiliation:
Comparative Audit Service, Surgical Epidemiology and Audit Unit, Royal College of Surgeons of England, Lincoln's Inn Fields, London, UK.
Rowena Ryan
Affiliation:
Comparative Audit Service, Surgical Epidemiology and Audit Unit, Royal College of Surgeons of England, Lincoln's Inn Fields, London, UK.
Raymond Rivron
Affiliation:
Comparative Audit Service, Surgical Epidemiology and Audit Unit, Royal College of Surgeons of England, Lincoln's Inn Fields, London, UK.
*
Address for correspondence: Mr P. M. Brown, ENT Department, Milton Keynes General NHS Trust, MK6 5LD.
Get access Rights & Permissions [Opens in a new window]

Abstract

An audit of day surgery was carried out by the Royal College of Surgeons (Eng.) Comparative Audit service. Data from 121 respondents on over 3 962 day cases were analysed from both retrospective information and from prospective individual patient proformas. The day surgery rate is 31 per cent. The variability of facilities for day-surgery, the timing of lists, type of anaesthetic used and case-mix are discussed. Outcome and the reasons for admission to an overnight bed are analysed. The overall admission rate was found to be 2.8 per cent (range 0.6–19.5 per cent between consultants). Seventy per cent of ENT day-surgery was performed on morning lists which have a lower admission rate than afternoon lists. The main reasons for admission are vomiting 30 per cent, haemorrhage 20 per cent and inadequate recovery from anaesthetic 22 per cent. A more detailed analysis of reasons for admission were given for tonsillectomy, adenoidectomy, FESS, and grommets. Recommendations are given which might increase the scope of safe day-surgery and reduce admission rate.

Keywords

Day care, surgeryPeer reviewOtolaryngology
Type
Audit Article
Information
The Journal of Laryngology & Otology , Volume 112 , Issue 2 , February 1998 , pp. 161 - 165
Copyright
Copyright © JLO (1984) Limited 1998

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ahmed, K., McCormick, M. S., Baruah, A. K. (1993) Day-case adenoidectomy – is it safe? Clinical Otolaryngology 18: 406–409.CrossRefGoogle ScholarPubMed
Audit Commission 1990. A Short Cut to Better Services, Day Surgery in England and Wales.Google Scholar
Audit Commission District Audit Service, 1992. A Review of Day Surgery – Oxford Regional Health Authority.Google Scholar
Buckley, J. G., Mitchell, D. B., Hickley, S. A., Fitzgerald O'Connor, A. F. (1991) Submucous resection of the nasal septum as an outpatient procedure. Journal of Laryngology and Otology 105: 544–546.CrossRefGoogle ScholarPubMed
Department of Health, 1993. H93/977. Press release.Google Scholar
Garth, R. J. N., Cox, H. J., Thomas, M. R. (1995) Haemorrhage as a complication of inferior turbinectomy: a comparison of anterior and radical trimming. Clinical Otolaryngology 20: 236–238.CrossRefGoogle ScholarPubMed
Grainger, C., Griffiths, R. (1994) Day surgery – How much is possible? A Delphi consensus amongst surgeons. Public Health 108: 257–2617.CrossRefGoogle Scholar
Kendrick, D., Gibbin, K. (1993) An audit of the complications of paediatric tonsillectomy, adenoidectomy, and adenotonsillectomy. Clinical Otolaryngology 18: 115–117.CrossRefGoogle ScholarPubMed
Leighton, S. E. J., Rowe-Jones, J. M., Knight, R., Moore-Gillon, V. L. (1993) Day case adenoidectomy. Clinical Otolaryngology 18: 215–219.CrossRefGoogle ScholarPubMed
Maniglia, A. J., Kushner, H., Cossi, L. (1989) Adenotonsillectomy: A safe outpatient procedure. Archives of Otolaryngology - Head and Neck Surgery 102: 161–168.Google Scholar
NHSME Caring for children in the health services, 18th 07 1989. Letter to BAOL Secretary.Google Scholar
NHSME Day surgery task force report, 1993.Google Scholar
NHSME value for money unit, 1991 Day surgery: Making it Happen.Google Scholar
Oxford Regional Audit Office, 04 1993. Audit of ENT Surgery across the Oxford Region.Google Scholar
Royal College of Surgeons of England, 03 1992. Guidelines for Day Case Surgery. Revised Edition.Google Scholar
Royal College of Surgeons of England Comparative Audit Report, 08 1993. Final Analysis of 1991 ENT Surgery Data.Google Scholar
Royal College of Surgeons of England Comparative Audit Report, 07 1994. Final Analysis of 1992 ENT Surgery Data.Google Scholar
Royal College of Surgeons of England Comparative ENT Audit Meeting, 19th 04 1996. Day Case Adenoidectomy – An Upward Audit Spiral.Google Scholar
Srinivasan, V., Arasarathnam, R. B. S., Jankelowitz, G. A. (1995) Day-case septal surgery under general anaesthesia and local anaesthesia with sedation. Journal of Laryngology and Otology 109: 614–617.CrossRefGoogle ScholarPubMed
Tewary, A. K.Day-case tonsillectomy: A review of the literature. Journal of Laryngology and Otology 107: 703–705.CrossRefGoogle Scholar
Wagner, G. A. L. (1991) Ambulatory day case tonsillectomy. Journal of Otolaryngology 20(1): 33–34.Google Scholar
Yardley, M. P. J. (1962) Tonsillectomy, adenoidectomy and adenotonsillectomy: are they safe day case procedures? Journal of Laryngology and Otology 106: 229–300.Google Scholar