WTP2.10 Appendicitis Patient Pathway at an East Midlands Hospital - a closed loop audit

Background GIRFT data shows only 12.4% of patients in Leicester, Leicestershire, and Rutland (LLR) achieve the target 2-day length of stay (LOS) and place the region in the highest quartile for average LOS. An initial audit in 2023 found just 4.4% of patients met the target LOS. Since then, theatre and imaging capacities have increased. Aims This study aimed to evaluate overall LOS and time intervals between admission, imaging, operation, and discharge. Secondary aims included assessing digital consent adoption following its departmental implementation in 2022. Methods Data from 91 adult patients undergoing laparoscopic appendicectomy between 04/01/2023 and 04/03/2023 were analysed. Paediatric cases were excluded. Times for admission, imaging, operation, and discharge were retrieved from ICE, ORMIS, and Concentric Health. Data were analyzed using Excel, with weekday and weekend admissions compared via independent samples median tests. Results Mean times were: presentation to imaging (8.91 hours), imaging to operation (26.82 hours), operation to discharge (53.94 hours), and total LOS (3.74 days). LOS improved to 3.7 days (from 4.3), with 14.3% meeting the 2-day target. Imaging-to-operation time decreased significantly (29.15 vs. 26.82 hours, p=0.003). Weekend admissions had significantly shorter imaging-to-operation times (36.23 vs. 21.91 hours, p<0.01). Digital consent adoption increased to 98% from 78% last year. Conclusions LOS and time intervals have improved with enhanced imaging and weekend capacity, alongside increased digital consent uptake. However, LLR remains in the highest GIRFT quartile, necessitating further optimisation.