Authors (including presenting author) :
Wong L(1), Suen TKD(1), Kwong A(1)
Affiliation :
(1)Department of Surgery, Queen Mary Hospital
Introduction :
Numerous studies have proven the safety and cost effectiveness of same day admission for surgery and the move toward same-day surgical services has been phenomenal in recent years. However, the rate of same day admission for breast surgery was low in Queen Mary Hospital (QMH). A remodeling of service has been introduced to improve same day admission since May 2017.
Objectives :
To assess the performance of same day admission for hookwire localization excision of breast lump in QMH
Methodology :
A workflow of timely pre-anesthetic assessment, efficient booking of operation and related procedures, and arrangement of same day operation ward admission was formulated with the conjoint effort of surgeons, anesthetists, radiologists, and nurses. The service remodel was started in May 2017.
Result & Outcome :
Results:
Before the implementation of the service remodel, the rate of same day admission for hookwire localization excision of breast lump was 10.3%. From May 2017 to December 2018, totally sixty-six patients were admitted for hookwire localization excision of breast lump in QMH. Fifty-six patients (84.8%) were admitted as same day admission. Ten patients did not admit as same day. Nine of them needed pre-operative in-patient care to optimize the medical condition, for example, Dextrose-Potassium-Insulin (DKI) infusion for insulin dependent diabetic patients while fasting for operation, and heparinization for patients on anti-coagulant. One patient failed to admit same day because pre-operative anesthetic assessment could not be arranged as the patient was out of town. All operations ran smooth and the patients recovered well after surgery with no major complication. Conclusions:
Even in QMH, where most complex operations were preformed, same day admission for surgery is feasible following a pathway supported by multiple disciplines.
Co-location with:
