LAUSR

This closed loop audit aimed at improving efficiency of time management with good utilisation of the first hour of the day in emergency theatres. This was reflected on bed management and patient service. Patients who required simple emergency operations were the target population. Retrospective data of patients’ demographics, time of attendance to surgical admission unit, time waiting for an operation, anaesthetic start times, surgical start times and postoperative inpatient stay were collected. Then the Golden patient pathway was implemented via a list of agreed criteria for the Golden patient (simple procedure, non-septic, non-diabetic, etc.). The chosen patient was labelled as Golden on the booking form. A precise time scale for anaesthetic review and theatre sending time was agreed. This pathway was tried for a month followed by data collection to compare outcomes. After starting the Golden patient pathway in our emergency surgery service, the mean anaesthetic start time (+/- standard deviation) improved from 09:12 +/- 0.11 to 08:32 +/- 0.01. Consequently, the mean operation start time improved from 09:45 +/- 0.10 to 08:53 +/- 0.01. The percentage of patients with same day discharge after simple procedures increased from 57% to 100% thus providing better use of hospital beds. The Golden patient pathway provides a good utilisation of the first hour of the day in emergency theatres. It has a positive impact on patient service and bed management via reducing the waiting times. The Golden patient pathway is an asset to the emergency general surgery service.