767 A Retrospective Analysis of Unplanned Admissions in Inguinal Hernia Repairs, Laparoscopic Cholecystectomies and Para-Umbilical Hernia Repairs (Day Surgery) Against the GIRFT Guidelines

Abstract Aim Getting It Right First Time (GIRFT) is a national initiative to homogenise and improve the treatment pathways amongst various NHS trusts. Unplanned admission after day case surgery results in unexpected cost and burden to the NHS. In this study, we investigated the causes for unplanned admission of patients undergoing laparoscopic cholecystectomy, paraumbilical and inguinal repair. Method A retrospective analysis of day cases over a period of one-year (January 2022 – January 2023) was undertaken. All patients’ pathways were compared against the GIRFT pathway. Result A total of following cases were included: 51/232 (22%) laparoscopic cholecystectomy, 7/48 (14.5%) paraumbilical hernia, and 18/152 (12%) inguinal hernia cases had unplanned admissions. The main causes for unplanned admissions for laparoscopic cholecystectomy were high-risk patients booked as day case (5 cases), complex intra-operative procedures (11 cases), and post-op complications/social reasons (4 cases); for paraumbilical hernia, the causes included social concerns, obstructive sleep apnea, extended post-op recovery; for inguinal hernia the main causes were urinary retention (5 cases) and high-risk patients booked as day case (11 cases). Conclusions For majority of cases, the GIRFT pathway was followed. Most of the unplanned admissions had predictable and preventable causes.