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Abstract

Introduction: In the modern public healthcare system such as the National Health Service (NHS), hospital capacity is under tremendous pressure due to acute admissions. This has a significant impact on elective surgeries as elective admissions have to be cancelled due to scarcity of beds. Cancellation of elective surgery means loss of major income for many public-funded hospitals. Aim: We introduced a pilot nurse-led discharge service for paediatric patients who require overnight admission elective tonsillectomy and adenotonsillectomy. Conventionally, these patients were discharged the next day having seen by doctors. Through this service we hope to facilitate the discharge process allowing patients to go home earlier and also improve the bed capacity for elective paediatric surgeries. Methods: A prospective audit of adenotonsillectomies and tonsillectomies was performed. The time of discharge and reasons for delayed discharge for this cohort were retrieved from notes and Epic, and analyzed. Results: A total of 62 patients were included. 41 patients stayed overnight. 28 patients (68%) went home before 12 pm the next day. The rest of the patients had delayed discharge due to various reasons such as medical complications and slow to resume oral intake. This can potentially be a 100% nurse-led discharge group of patient if difficult discharges can be predicted. Conclusion: Nurse-led discharge service is a valuable tool in facilitating the discharge processes, thus increasing bed capacities for elective surgeries. This service should be gradually introduced to other surgical specialties to improve the health care service in a public funded hospital.

Biography

Billy Wong is a core surgical trainee aiming to pursue Otolaryngology as a career. He has special interest in Paediatrics Otolaryngology and Head and Neck Surgery. He was a part of Addenbrooke?s Hospital for 12 months and published a number of articles during that period there.