Are we delivering an effective day case / 23-hour breast surgery service?
Association of Breast Surgery ePoster Library. Pereira B. 05/15/17; 166292; P039
Ms. Bernadette Pereira
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Abstract
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Introduction
There is growing body of evidence which suggests that breast cancer surgery (except reconstruction) consists of relatively short operations with low post-operative pain where patients mobilise early. In 2007 the NHS Improvement “Transforming Inpatient Care Programme”, as a part of Cancer Reform Strategy, redesigned the breast surgical pathway with the working hypothesis that “streamlining the breast surgical pathway could reduce length of stay (LOS) by 50% and release 25% of unnecessary bed days for 80% of major breast surgery”. Our aim was to assess our unit's pathway, implement the necessary changes to bring it up-to-date with the national standards.
Methods
Retrospective data was collected from May 2013- May 2016 of all the breast cancer operations such as Mastectomy, wide local excisions, re-excision and axillary surgery. From Jan 2015, we implemented new changes of “no drain policy” for all operations (except reconstruction).
Results
From May 2013-May 2014, 89/123(72.3%) of patients undergoing breast cancer procedures (except Reconstruction) were discharged as daycase / 23hours. In Jan 2015 after we changed practice of “no drain policy” we saw a rise in our daycase /23hour discharges to 99/117(84%) from May 2014-15, with a continuing increase in our daycase /23hour discharges rising to 127/147 (86.39%) in May 2015-16.
Conclusions
Nationally, good progress has been made with 72% of breast surgery patients benefitting from the pathway. At our DGH we have managed to surpass this target through our “no drain policy”, non-opioid analgesia and appropriate aftercare thus conforming to the national standards and reducing length of stay and costs.
There is growing body of evidence which suggests that breast cancer surgery (except reconstruction) consists of relatively short operations with low post-operative pain where patients mobilise early. In 2007 the NHS Improvement “Transforming Inpatient Care Programme”, as a part of Cancer Reform Strategy, redesigned the breast surgical pathway with the working hypothesis that “streamlining the breast surgical pathway could reduce length of stay (LOS) by 50% and release 25% of unnecessary bed days for 80% of major breast surgery”. Our aim was to assess our unit's pathway, implement the necessary changes to bring it up-to-date with the national standards.
Methods
Retrospective data was collected from May 2013- May 2016 of all the breast cancer operations such as Mastectomy, wide local excisions, re-excision and axillary surgery. From Jan 2015, we implemented new changes of “no drain policy” for all operations (except reconstruction).
Results
From May 2013-May 2014, 89/123(72.3%) of patients undergoing breast cancer procedures (except Reconstruction) were discharged as daycase / 23hours. In Jan 2015 after we changed practice of “no drain policy” we saw a rise in our daycase /23hour discharges to 99/117(84%) from May 2014-15, with a continuing increase in our daycase /23hour discharges rising to 127/147 (86.39%) in May 2015-16.
Conclusions
Nationally, good progress has been made with 72% of breast surgery patients benefitting from the pathway. At our DGH we have managed to surpass this target through our “no drain policy”, non-opioid analgesia and appropriate aftercare thus conforming to the national standards and reducing length of stay and costs.
Introduction
There is growing body of evidence which suggests that breast cancer surgery (except reconstruction) consists of relatively short operations with low post-operative pain where patients mobilise early. In 2007 the NHS Improvement “Transforming Inpatient Care Programme”, as a part of Cancer Reform Strategy, redesigned the breast surgical pathway with the working hypothesis that “streamlining the breast surgical pathway could reduce length of stay (LOS) by 50% and release 25% of unnecessary bed days for 80% of major breast surgery”. Our aim was to assess our unit's pathway, implement the necessary changes to bring it up-to-date with the national standards.
Methods
Retrospective data was collected from May 2013- May 2016 of all the breast cancer operations such as Mastectomy, wide local excisions, re-excision and axillary surgery. From Jan 2015, we implemented new changes of “no drain policy” for all operations (except reconstruction).
Results
From May 2013-May 2014, 89/123(72.3%) of patients undergoing breast cancer procedures (except Reconstruction) were discharged as daycase / 23hours. In Jan 2015 after we changed practice of “no drain policy” we saw a rise in our daycase /23hour discharges to 99/117(84%) from May 2014-15, with a continuing increase in our daycase /23hour discharges rising to 127/147 (86.39%) in May 2015-16.
Conclusions
Nationally, good progress has been made with 72% of breast surgery patients benefitting from the pathway. At our DGH we have managed to surpass this target through our “no drain policy”, non-opioid analgesia and appropriate aftercare thus conforming to the national standards and reducing length of stay and costs.
There is growing body of evidence which suggests that breast cancer surgery (except reconstruction) consists of relatively short operations with low post-operative pain where patients mobilise early. In 2007 the NHS Improvement “Transforming Inpatient Care Programme”, as a part of Cancer Reform Strategy, redesigned the breast surgical pathway with the working hypothesis that “streamlining the breast surgical pathway could reduce length of stay (LOS) by 50% and release 25% of unnecessary bed days for 80% of major breast surgery”. Our aim was to assess our unit's pathway, implement the necessary changes to bring it up-to-date with the national standards.
Methods
Retrospective data was collected from May 2013- May 2016 of all the breast cancer operations such as Mastectomy, wide local excisions, re-excision and axillary surgery. From Jan 2015, we implemented new changes of “no drain policy” for all operations (except reconstruction).
Results
From May 2013-May 2014, 89/123(72.3%) of patients undergoing breast cancer procedures (except Reconstruction) were discharged as daycase / 23hours. In Jan 2015 after we changed practice of “no drain policy” we saw a rise in our daycase /23hour discharges to 99/117(84%) from May 2014-15, with a continuing increase in our daycase /23hour discharges rising to 127/147 (86.39%) in May 2015-16.
Conclusions
Nationally, good progress has been made with 72% of breast surgery patients benefitting from the pathway. At our DGH we have managed to surpass this target through our “no drain policy”, non-opioid analgesia and appropriate aftercare thus conforming to the national standards and reducing length of stay and costs.
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