TPW 9.17 Streamlining Emergency Care: Piloting an Ambulatory Pathway for Benign Surgical Conditions in a District General Hospital
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ID: 323950
2026
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Abstract
Abstract Aims To establish and assess an ambulatory emergency surgery pathway for selected general surgical conditions. Methods Inclusion criteria targeted low-risk patients (no systemic sepsis) requiring (1) incision and drainage of abscesses, (2) surgical management of thrombosed or prolapsed internal haemorrhoids or (3) EUA rectum for anal pain. . A pathway checklist was developed, and the policy was approved at senior level. The pilot ran for 11 weeks, followed by a retrospective audit. A teaching session and results presentation were delivered to surgical consultants and residents. The proforma has been revised to improve usability. Reaudit was then undertaken. Results Round 1 July-Sept 2025 (pilot): 22 eligible patients were identified through retrospective audit after launch of the pathway; 19 met the full criteria, and 3 were excluded. Only 4 patients were managed through the complete pathway. Round 2 Sept-Dec 2025: Cohort of 42 patients –expanded to include all suitable conditions as specified above: Subcutaneous abscess, perianal abscess and perianal pain requiring examination under anaesthesia of anorectum. 33 remaining after excluding those with threat to life/ sepsis/ too frail for ambulatory surgery.19 were managed through full pathway as intended. 6 brought back to other areas. Conclusions The ambulatory pathway is a feasible approach for managing benign surgical conditions without hospital admission. Uptake was initially low (4/22), mainly due to non-ring-fenced day surgery beds competing with elective lists and possible patient reluctance. Expected benefits include reduced inpatient bed pressure, quicker recovery, fewer hospital-acquired complications, and earlier return to normal activity.
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openalex_W7172517475
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| Authors | Stephen Davison, Pedro Cunha, Michael Dick |
| Journal | the british journal of surgery |
| Year | 2026 |
| DOI |
10.1093/bjs/znag087.415
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| URL | |
| Keywords | Keywords not found |
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