Mater Dei registers low rate of delayed discharges from day-care unit

Mater Dei Hospital’s day care unit has favourable rates of delayed discharges and unplanned admissions, a study by three doctors from the Department of Anaesthesia and Intensive Care has found.

Of 3,599 patients admitted to the day care unit over 45 days (March-April 2014) – of whom 1,855 were for day surgeries and 1,744 as endoscopy cases – just 142 were not discharged as planned.

Fifty patients had their discharge delayed by up to five hours, and 92 required overnight admission following a day-case procedure. Most of the delayed cases had received a general anaesthetic (95%).

A discharge is considered as delayed when it occurs after 6pm on the same day. “Mater Dei Hospital has a reasonable rate of delayed discharges and unplanned admissions following day procedures, especially when compared with data from UK hospitals,” researchers Jessica Sant, Glenn Paul Abela, and Daniel Farrugia wrote in their study.

Day surgery entails admitting patients to hospital for a planned surgical procedure, after which the patient returns home on the same day – reducing waiting times and lessening hospital costs.

At a rate of 5.5% of unplanned admission for day surgeries, Mater Dei’s rate was above the Royal College of Anaesthetists’ 2% standard, but was still less than some centres in the UK, such as the Newham University Hospital in East London (10.3%) and the Forth Valley Royal Hospital in Larbert, Scotland (6.6%).

“There is definite need for better documentation by both clinicians and nursing staff,” the researchers said of the need to upgrade dayto-day practices.

“There were too many cases whose discharge was either delayed or who were admitted without any justification found in the case notes. Also, too many patients were admitted to hospital because their procedure started late in the day… this may point towards the need of extending day care unit opening hours beyond 6pm, as well as the scheduling of day cases earlier during the day,” they add.