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

Phillip F Yang1,2,3, Lily Builth-Snoad1, Kheng-Seong Ng1,2,4,5

  • 1Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.

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PubMed
Summary

Implementing an acute day-only surgery (ADOS) program for abscess drainage in Australia is feasible and safe. This initiative reduces hospital stays and costs without compromising patient outcomes or impacting overall emergency theatre workflow.

Keywords:
abscessambulatory surgical procedurescosts and cost analysisdrainagelength of stay

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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.