Improving patient outcomes, trainee supervision and resource allocation with acute operating lists
BAUS ePoster online library. Loganathan A. Jun 25, 2019; 259469; P10-1
Ajanthan Loganathan
Ajanthan Loganathan
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Abstract
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Introduction:
We introduced a regular acute urology operating session in 2015 with the aim of ensuring high quality consultant led emergency care, improving trainee supervision and increasing primary ureteroscopy for patients with urinary tract stones.

METHODS:

We examined a prospectively collated database of the acute-list operations and analysed outcomes and the potential benefits for surgical resources and training.

Results:

Since 2015, 608 patients have been treated on the acute urology operating list. All lists were directly supervised by a consultant urologist and staffed by urologically trained theatre staff. 89% of cases were performed by a urology trainee under direct consultant supervision; 11% of cases were performed by a consultant urologist. There has been a year-on-year reduction in out of hours operating with proportion of out-of-hours procedures being 44%, 33%, 30% and 11% for the consecutive years 2015-2018. There was also a reduction in the number of emergency cases being treated on elective surgical lists from 40% to 15%. 96% of patients with non-infected ureteric stones who were treated on the acute list had an attempted primary ureteroscopy with a stone clearance rate of 85%.

Conclusion:
The introduction of the designated urological acute theatre has allowed supervised emergency surgery to be carried out in a safe environment with appropriate consultant cover. The ability to perform regular primary ureteroscopy has reduced the burden of stent related morbidity and impact on elective operating lists for staged stone surgery.
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