Clinical indicators for day surgery

As the number, variety and complexity of day procedures increase it is clearly important to ensure maintenance (and improvement) in the quality of the care given. To do so the Australian Day Surgery Council, assisted by the Australian Council on Healthcare Standards Care Evaluation Program, introduced five generic performance indicators. They were addressed by 240 healthcare organisations in 1997 reflecting the management of over 380 000 patients in day procedure facilities. Aggregate rates for the five indicators in 1997 were: failure to arrive, 1.5%; cancellation of procedure after arrival, 0.9%; unplanned return to operating room, 0.08% and unplanned delayed discharge, 0.56%. The unplanned overnight admission rate was significantly lower in freestanding than in attached facilities and significantly lower rates were noted for private compared with public facilities for all the indicators. Numerous actions were reported by 64% of organisations (as a result of indicator monitoring) including increased patient education, the production of information leaflets, establishment of pre-anaesthetic clinics, alteration of surgical techniques, introduction of drug trials and numerous policy changes.