Elective Surgery Programme Implementation Support Guide

The Clinical Director, commonly a Consultant Surgeon or Anaesthetist, should be given
dedicated sessional time to provide clinical leadership for the development of day
surgery services, ensuring that consistent policies and guidelines are adopted across all
surgical specialties. He or she should lead on clinical governance with particular
emphasis on clinical risk management and audit and regular review of day surgery
performance metrics.
The Nurse Manager should support the Clinical Director in developing clinical protocols
and guidelines and provide clinical leadership in nursing practice to ensure that the
nursing staff has the necessary skills and competencies. He or she should be
responsible for the day to day management of the unit and contribute to the strategic
development of the service.
The Administrator should support the Clinical Director and Manager and should be
responsible for the efficient management of admissions and waiting lists. The
administrator should also be responsible for database management with respect to
monitoring of day surgery performance and produce regular reports for review by the
operational group as outlined in this document.
A Working Group should establish the governance structure and develop the service
locally for each surgical service as appropriate. Such a team should include,
o The Clinical Director
o A consultant anaesthetist and surgeon.
o The Nurse Manager
o The Theatre Manager
o Representation from senior management
o Representation from radiology, laboratory, allied healthcare services
o The Waiting list/Admission Coordinator for elective surgery patients
o Representation from community service
o Patient advocacy
o General Practitioner
Day surgery should be represented at the Hospital and Medical Board.
Policies & protocols
Clear policies and protocols should be in place (for example, see APPENDIX 1 (Chapter 2) –
guidelines for pre-operative fasting and peri-operative administration of drugs) to help
ensure the smooth running of the unit. These should include policies to ensure:
69 Model of Care for Elective Surgery