Introduction
Co-morbid high risk patients are often denied access to satellite Day Surgery hospitals due to the perceived risks of general anaesthesia in a non-tertiary centre. To address this, The New Stobhill Hospital, Glasgow, introduced a block room in October 2024 as part of their orthopaedic service within the Day Surgery Unit making awake regional anaesthesia the default anaesthetic type.
Methods
Using the pre-existing suitability decision tool for 23hr stay procedures we reviewed the first 6 months of patients through the block room to determine the number of red (high risk patients requiring tertiary hospital surgery only) and amber (need further pre-operative assessment before deciding on site suitability) patients that were successfully undergoing day case surgery.
Results
Between October 2024 and March 2025, 108 patients accessed the block room service undergoing upper and lower limb orthopaedic surgery.
7.4% of the patients were classified as red and would previously not have been considered for day case surgery. 32.4% were categorised as amber and would require further anaesthetic review before deciding if they could proceed.
Conclusions
The introduction of a block room service has notably widened access to day case surgery whereby almost 40% of cases were classified as medium to high risk. Not only does this have benefits for the patient undergoing surgery quicker but also relieves bed pressures on the tertiary hospital. It would be our hope to streamline the pre-operative assessment pathway for these patients and in so doing reduce the workload for our pre-operative teams.
Authors
Mark Tait
The New Stobhill Hospital, Glasgow, United Kingdom
Glasgow Royal Infirmary, Glasgow, United Kingdom
Eoghan Meaney
NHSGGC, Glasgow, United Kingdom
Lindsay Hudman
NHSGGC, Glasgow, United Kingdom
David Macpherson
NHSGGC, Glasgow, United Kingdom