Audit of paediatric day-case surgery in a district general hospital

Day-case surgery is a major component of the workload in our hospital (Our Lady of Maryknoll Hospital, Kowloon, Hong Kong). We choose to audit paediatric day-case surgery because the patients’ parents are anxious and therefore likely to reflect the finest details of care. The study was prospective. In a one-year period (1997), the 235 paediatric day-case surgery cases scheduled in our hospital accounted for 90% of all paediatric operations. The patients’ attendance rate was 98.8%. Five patients (2.2%) were kept overnight for observation. Six patients (2.6%) were re-admitted after operation. There were 50 (22%) telephone hotline enquiries. The overall minor complication rate, as defined, was 4.8% and there was no major morbidity. A multidisciplinary approach including anaesthetists and nurses was the key to sucess. Easy access to medical advice was also important in order to avoid unnecessary re-admission and parental anxiety. The well-organized day-surgery service was safe, well-accepted and cost effective.