Daycare Surgery

1. Write short notes on:
a) Pre-requisites for daycare surgery (17 marks)
b) How to monitor daycare surgery success (3 marks)
Clinical Factor
• Patient age >6 months and <75 years old
• BMI <35kgm2
• No difficult airway features
• ASA 1 or 2 with well controlled comorbidities
• LA cases selection based on surgeon’s discretion
• Patient’s assessment to be done 2 weeks prior to surgery date
• Prior blood, imaging and relevant investigations done reviewed

2. Social factor
• Patients/parents able to provide informed consent and willing to
co-operate to post procedural instructions
• Escort: Carer should be responsible to escort patient and provide
supervision at least 24 hours post procedure. Paediatric patients
needs at least 2 adults to drive and care for child
• Transport: Suitable transport to home post-surgery and if using public
transport to ensure suitable mode of transportation. Not advisable to
use motorcycle
• Geography: Live within 1 hour travelling distance from hospital
• Social: Access to telephone services available at all times

3. Surgical Criteria
• Simple surgery lasting <90 minutes
• Less post operative risk of haemorrhage or airway compromise
• Procedures with less post-operative pain that can be controlled by
oral analgesia
• Post operative requires no special nursing/care
• Able to resume food and fluid intake in a short period post op
• No prolonged immobility post op

4. • Daycare surgery success based on short term (2-3 years) and long
term target (4-5 years) target
1. Effectiveness
• No of procedures done under daycare over overall total no of cases
- Short term ≥ 10% , Long term ≥25%
2. Quality
• Unplanned admission
- Short term <5%, Long term <1%
• No show
- Short term <5%, Long term <1%
• Cancellation rate
- Short term <15%, Long term <10%

5. 3. Customer’s satisfaction
• Via feedback from patients
- Short term >85%, Long term >95%