Elective Surgery Programme Implementation Support Guide

Accommodation required for day surgery
Different models:
1. A self-contained day surgery unit, with its own admission suite, wards, theatre and
recovery area, together with administrative facilities. This is ideal but not widely
available. It is also the most cost effective option (12).
2. A day-case ward with patients going to the main operating theatre where lists may be
made up entirely of day cases. Although less satisfactory this arrangement is quite
commonly used.
3. A day-case ward with patients going to the main operating theatre where mixed lists of
day cases and inpatients are operated on. Although less successful this is currently
probably the most common situation in Ireland. In these circumstances Day cases must
be performed first on the list to ensure that they go home on that day.
4. Day surgery performed using inpatient wards and inpatient operating theatres is the
least successful model and is not recommended. The stay-in rate (unsuccessful
discharge of patients home on the day of surgery) rises from 2.4% in a free standing unit
to 14% in an inpatient ward .(13)
In smaller centres there may be some advantages to housing day surgery and endoscopy in
adjacent areas and sharing some facilities, such as recovery. For larger units separate premises
for endoscopy are desirable.
Accommodation for day surgery should contain an isolation room for infection prevention and
control purposes (e.g., for isolation of patients colonised with MRSA).
Additional facilities for day surgery
Facilities will vary according to the needs of different hospitals.
i. Car parking: Day surgery patients need access to car parking, and at least a shortstay
drop off and pick up point immediately adjacent to the unit or ward.
ii. Reception: Patients and relatives need adequate sitting accommodation while waiting
67 Model of Care for Elective Surgery