Beruflich Dokumente
Kultur Dokumente
A. Mahon, M. McCarthy, M.A.C. Craigen, V. Rajaratnam, O.G. Titley, F. Peart, M.A. Waldram
The Birmingham Hand Centre, Selly Oak Hospital, Birmingham, UK.
Discussion
Prior to the implementation of the Day Case Hand Surgery protocol, we
found that the majority of patients referred to our unit were admitted
to await surgical treatment. As the majority of such injuries are neither
life nor limb threatening, they are not seen as a priority for surgery.
This frequently results in delayed treatment, beds being occupied by
patients who are receiving nothing more than oral medication, patient
dissatisfaction and ultimately, complaints about treatment.
The introduction of dedicated day theatre lists for hand trauma and a
senior nurse to coordinate the hand trauma lists and liase with patients
has improved the situation considerably. Although patients may still
wait several days for surgery, they now do so at home. They are
informed at an early stage, when they are likely to undergo surgery and
cancellations are rare. This has resulted in greater patient satisfaction as
indicated by a 99% reduction in complaints. A prior study carried out in
our unit has shown further objective evidence of patient satisfaction by
using the SERVQUAL tool.
Treating hand trauma patients as day cases has not led to an increase in
complications and this may be related to the use of a strict protocol.
Conclusions
The introduction of a hand coordinator led, day case emergency hand
surgery protocol has resulted in a marked increase in the number of
patients treated, and reduced the burden on main theatre. In addition The Birmingham Hand Centre
there is better patient satisfaction. We feel that this is a good model
for the organisation of a hand trauma service.