Optimizing theatre utilization for abscess drainage: going beyond priority categories.

Area of Science:

• Surgical innovation
• Health services research
• Emergency medicine

Background:

• Day-only emergency surgery for abscess drainage is underutilized in Australia.
• This study evaluated the feasibility and impact of an acute day-only surgery (ADOS) program for abscess management.

Purpose of the Study:

• To assess the feasibility, patient outcomes, cost-effectiveness, and impact on theatre workflow of an ADOS program for abscess drainage.
• To compare outcomes before and after ADOS implementation.

Main Methods:

• A retrospective pre-post implementation study design was employed.
• Patients undergoing abscess drainage were compared between a pre-ADOS period (6 months) and an ADOS era (12 months).
• Primary outcome was length of hospital stay (LOS); secondary outcomes included 30-day complications, costs, and theatre workflow metrics.

Main Results:

• Median LOS significantly decreased from 30.1 hours (pre-ADOS) to 21.9 hours (ADOS era), with ADOS pathway patients averaging 10.2 hours.
• No significant differences were observed in 30-day complications, re-presentations, or abscess recurrence rates.
• Average cost per patient was reduced in the ADOS era ($4155 vs. $4916).

Conclusions:

• Acute day-only surgery for abscess drainage is a feasible and safe model.
• The ADOS program demonstrates significant cost savings and reduced hospital stays.
• Implementation requires no significant additional resources and does not negatively affect other emergency procedures.