The 'hub' model for colorectal surgery: a viable paradigm shift?

Area of Science:

• Surgical innovation
• Healthcare management
• Public health

Background:

• Post-COVID-19 lockdown, 7 million patients faced elective surgery waiting lists.
• The Royal College of Surgeons proposed a 'New Deal for Surgery' using COVID-light sites and elective hubs.
• This study evaluates the short-term outcomes, safety, and sustainability of the elective hub model.

Purpose of the Study:

• To assess the efficacy and safety of the elective hub model for major colorectal surgery.
• To evaluate patient outcomes, including complications, readmissions, and length of stay.
• To determine the sustainability and system resilience benefits of the hub model.

Main Methods:

• Analysis of all major elective colorectal operations performed at the hub between March 2021 and March 2022.
• Inclusion of data on patient demographics, operative performance, and postoperative outcomes.
• Statistical analysis using SPSS 27.

Main Results:

• 401 cases were analyzed with a 0.2% same-day cancellation rate.
• 8.2% experienced severe complications (Clavien-Dindo grade ≥3), and 8.5% required transfer for higher care.
• 11.5% had 30-day readmissions, and 0.4% mortality rate was observed.

Conclusions:

• The elective hub model demonstrated efficacy and safety in managing high volumes of major colorectal surgery.
• Acceptable rates of major complications, transfers, and minimal patient displacement were noted.
• The model contributes to improved surgical system resilience and patient care post-pandemic.