Background: The aim of this project was to increase rates of day surgery, reduce elective surgical waiting lists, give patients a guaranteed date of surgery and improve operating theatre utilization. The guiding principle behind the project was to treat the administration of elective surgery as a separate business unit, distinct from emergency surgery.
Methods: Elective surgical referrals for admission from throughout the Western Sydney Health Area Service were pooled. The procedure for surgical admissions was altered in three areas: (i) the use of a new booking and waiting list system administered by a dedicated nurse coordinator who generated the lists for surgery; (ii) restructuring the elective surgical operating sessions; and (iii) planning post-discharge care at the time of operation using model clinical pathways.
Results and conclusions: During the project period, the number of the selected surgical procedures performed doubled. Fifty-seven per cent of patients were discharged on the day of surgery. Surgeons took less time to perform procedures. By the end of the trial period, waiting lists for the selected procedures were eliminated. Operating costs as evaluated by the Centre for Health Economics Research and Evaluation were reduced by 25%. The administrative changes to surgical admissions resulted in improved cost and patient throughput for elective surgical admissions with no adverse patient outcomes.