Improving the 'Golden Patient' Initiative at a British Major Trauma Centre: A Single-Centre Study.

Area of Science:

• Trauma Surgery
• Healthcare Management
• Patient Flow Optimization

Background:

• Delays in operating theatre start times incur significant costs and negatively impact patient outcomes.
• A Golden Patient (GP) protocol was implemented in a major trauma center to mitigate these delays.

Purpose of the Study:

• To determine the frequency of Golden Patients (GPs) being removed from the primary surgical list.
• To identify key factors contributing to GP step-downs in trauma surgery.

Main Methods:

• Data collection over an eight-week period, involving 80 Golden Patients (GPs).
• Recording patient demographics, injury type, location, and day of surgery for stepped-down cases.
• Univariate statistical analyses to identify significant contributing factors.

Main Results:

• The incidence of GPs being stepped down was 11.25%.
• Step-downs were significantly associated with patients being at home the night before surgery (p=0.0114) and cases scheduled on Fridays (p=0.0139).
• All stepped-down GPs who proceeded to surgery received their operation within one day.

Conclusions:

• The Golden Patient (GP) protocol demonstrates low step-down rates, comparable to pre-pandemic initiatives.
• Admitting planned GPs the night before surgery may reduce delays.
• While effective, the GP system offers opportunities for service efficiency improvements in major trauma centers.