Development in service provision. Making major elective surgery happen. The development of a postoperative surgical unit

BACKGROUND: Optimizing the provision of elective surgery and reducing waiting list times for elective surgery has been a central theme in this government's health-care agenda. The negative impacts of high levels of cancelled surgery have significant implications, for both patient and health-care resources. AIMS: To describe the development and initial impact of a postoperative surgical unit (POSU), an innovative strategy to optimize provision of major elective surgery. METHODS: Data were collected concerning numbers of cancellations of major elective operations during the first year of POSU's opening and for the previous year when high-dependency unit held the only available beds for these patients. Data were also collected concerning the outcome of the admission of these patients. All data collection was standardized. RESULTS: In the year prior to the opening of POSU, of 503 patients requiring level 2 care postoperatively, 317 underwent elective surgery and 186 patients had their surgery cancelled because of unavailability of level 2 beds. In POSU's first operational year, of 877 similar patients, 843 had elective surgery and 34 had their surgery cancelled because of unavailability of appropriate dependency beds. CONCLUSIONS: This small project has illustrated how POSU has had a positive impact on decreasing the waiting list times and led to low levels of cancelled major elective surgery. These outcomes have resulted in improvements in delivery of services to patients and in the utilisation of resources.