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An audit of the surgical workload on a renal unit
1Sheffield Kidney Institute, Northern General Hospital.
Objective:
To assess the surgical workload on a renal unit, with particular reference to non-transplant-related surgery and to assess the workload in relation to surgical staffing levels.
Design:
Prospective audit of all surgical procedures carried out on patients in acute or chronic renal failure, and on transplanted patients, within a one year period.
Setting:
A purpose-built renal unit serving a population of 1.7 million.
Main Outcome Measures:
The number of surgical procedures, both transplant and non-transplant-related, according to type and severity, with particular reference to the levels of surgical staffing.
Results:
Transplant-related surgery accounted for only 6.5 per cent of the total surgical workload (general, vascular and renal) of the 'transplant surgeons'. Taking into account only the renal-related workload, transplant-related surgery accounted for just 16.5 per cent of the workload, the remainder being related to vascular access and peritoneal access for dialysis, and general surgical procedures on patients in renal failure and transplanted patients. The surgical workload undertaken by a relatively small number of staff was high, representing 531 Intermediate Equivalents per Service Equivalent Value per annum.
Conclusions:
When assessing workload and adequacy of surgical staffing on a Renal Unit, care should be taken to account for all surgical activity on renal patients and not just that related to transplantation since only 16.5 per cent of the surgical workload is transplant-related.