[Structure and organization of ambulatory and day treatment in a non-university facility]

Though German hospitals are normally not built for day case surgery, this became a new challenge based on changed legal regulations. A stepwise adaptation of the present facilities to the altered necessities seems to be a relatively simple way to realise day case surgery also in hospitals. Preoperatively surgeons and anaesthetists offer office hours during the same time to avoid patients having to wait. On the day of surgery patients are admitted to the hospital and treated like inpatients with regular transport to the operating room for anaesthesia and surgery, followed by recovery room stay and transmission to the normal ward. At a fixed time in the afternoon patients are visited by the surgeon and the anaesthetist to clear the conditions for dismission. While anaesthesia, surgery and recovery take the same time as for inpatients, the pre- and postoperative procedures are more time consuming. With a rising number of outpatients a separate department for outpatient surgery with its own administration, operating theaters and day case ward should be developed.