534 A Retrospective Evaluation of Non-Clinical Limitations to Day Case Urology at a District General Hospital

Abstract Aim This service evaluation aimed to define the rate of 24 hour stay, following planned day case urological procedures, within the setting of our district general hospital main theatres. Of particular interest was the non-clinical reasons patients were admitted for longer than expected. Method Retrospective review of theatre schedule and eCare documentation, during January and February 2023. Excluding TURP and Nephrectomy, all other cases were included as potentially day case. Patients with a clinical reason to remain in hospital were not analysed further. All other patients remaining in hospital longer than 24 hours were investigated. Results Out of a total of 87 patients, 44 remained in hospital overnight. 19 patients had a clinical reason to remain. Other non-clinical reasons to stay included social circumstances (7), trial without catheter (TWOC) issues (3), patient preference (1). Inadequate documentation limited analysis in 13 patients. Conclusions Half of the patients attending for day case procedures in the main theatre were still in hospital at 24 hours. This limits the bed availability for the following morning’s operating, potentially leading to delays, cancellations, and poor patient satisfaction. The majority of these were for non-clinical reasons. Suggested improvements ahead of re-audit include educational sessions with ward nurses to empower nurse-led discharge into the evening, alongside a standardised procedure-specific discharge criteria; highlighting of anticipated day cases to bed managers early; avoidance of TWOC on day of procedure; and updating of patient information leaflets to highlight the expectation of same-day discharge.