Abstract
With the growing need for health services, proper bed capacity management is mandatory to avoid patient rejection or cancellation of a procedure. Hence, the day of surgery admission (DOSA) protocol is gaining popularity with safety concerns. We conducted this study in a 120-bed hospital. Our unit has four operating lists per week for elective cases. All patients who planned for elective surgery, with no medical illness or who had a controlled medical illness, were recruited. Every patient was seen in the surgical clinic with his plan of management written in his admission paper. Patients were admitted from 07:00 to 11:00 am through the special admission counter. We evaluated hospital stay, postoperative complications, and mortality. The total number of patients was 18,500 in a 13-year duration. The total number of case cancellations was 396 patients (2.1%). The general surgical procedures were 6987 (38%), the GIT procedures were 5469 (30%), the endocrine and breast procedures were 3545 (18%), the pediatric surgery procedures were 1431(8%), while urology procedures were 1068 (6%). The hospital stay was 1 day or less in 10,305 (56%) patients. The total number of patients who developed postoperative complications was 491 (2.6%). The mortality rate was 0.05% (10 patients). DOSA is a valid and safe protocol for selected patients. It minimizes hospital stays, reducing expenses. Adoption of DOSA will increase bed availability and avoid case cancellation.
Similar content being viewed by others
Data Availability
Data is available within the manuscript text and tables.
References
Harries RL, Bradshaw CA, Jones EA et al (2013) To admit or not to admit on the morning of surgery: patients’ perspectives on day of surgery admission. J Perioper Pract 23(3):56–58
Cella A, Bush C, Codignotto B (1993) Same-day admission for cardiac surgery is a benefit to patients, families, and institutions. J Cardiovasc Nurs 7(4):14–29
Ortiga B, Capdevila C, Salazar A et al (2010) Effectiveness of a surgery admission unit for patients undergoing major elective surgery in a tertiary university hospital. BMC Health Serv Res 10(23):1–5
Lincoln R, Leslie B, Anil K (2006) Outcomes after admission on the day of elective resection for colorectal cancer. ANZ J Surg 76(1–2):14–19
Ogg T, Hitchcock M, Penn S (1998) Day surgery admissions and complications. Ambul Surg 6:101–106
Part B – Health facility briefing & design 60-day surgery/procedure unit. International Health Facility Guidelines 2023 https://www.healthfacilityguidelines.com/ViewPDF/ViewIndexPDF/iHFG_part_b_day_surgery-procedure_unit. Accessed 18 Jan 2024
Anqaa A, Hamad A, Angela C et al (2022) Impact of a same day admission project in reducing the pre-operative bed occupancy demand in a pediatric inpatient hospital. Ann Med Surg 81:104304 :1–4
Gillian B (2016) Developing an effective day surgery service. Update Anaesth 31(6):9–13
Satish K, Harsoor S, Chandrasekar M et al (2017) Consensus statement on anesthesia for daycare surgeries. Indian J Anaesth 61(2):110–124
Bailey CR, Ahuja M, Bartholomew K et al (2019) Guidelines from the Association of Anaesthetists and the British Association of Day Surgery. Anaesthesia 74:778–792
Monalisa JM (2019) Perioperative management – II Day surgery guidelines. Surgery 37(12):706–711. https://doi.org/10.1016/j.mpsur.2019.10.007. (Oxford)
Power L, Thackray N (1999) Reduction of pre-operative investigations with the introduction of an anaesthetist-led pre-operative assessment clinic. Anaesth Intensive Care 27:481–488
Agbolahan S, James T, Richard P (2013) Patient and staff satisfaction with ‘day of admission’ elective surgery. Br J Neurosurg 27(2):146–151. https://doi.org/10.3109/02688697.2012.725872
Anqaa A, Hamad A, Angela C et al (2022) Impact of the same day admission project in reducing the pre-operative bed occupancy demand in a pediatric inpatient hospital. Ann Med Surg 81:1–4
Gangadhar SB, Gopal TM, Sathyabhama, et al (2012) Rapid emergence of daycare anesthesia: a review. Indian J Anaesth 56(4):336–341
Tom A, Martin W, Ruben C (2017) Day case surgery guidelines. Surgery 35(2):89–91. https://doi.org/10.1016/j.mpsur.2016.11.013. (Oxford)
Kulasegarah J, Lang JJ, Carlon A et al (2008) Day of surgery admission–is this safe practice? Ir Med J 101(7):218–219
Ian S, Claudine M, Reynolds IS et al (2019) Implementation of the day of surgery admission for rectal cancer surgery in Ireland following a national centralization program. Ir J Med Sci 188(3):765–769. https://doi.org/10.1007/s11845-018-1904-0
Keränen J, Keränen U (2011) From home to operation (FHTO) — a new surgical admission centre: does the comprehensive initialisation of a new process harm surgery outcome? Scand J Surg 100(2):136–140. https://doi.org/10.1177/145749691110000213
Thomas K, Stephen K, Anja H (2016) The role of DOSA-principle for German hospitals. J Anesth Crit Care Open Access 5(6):00205
Hamed A, Muaath KA, Alexandre C et al (2023) Day of surgery admission in urology: patient criteria and the organization required for same-day admission in urology: a retrospective study. Urol Ann 15:4,10-12
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Ethical Approval
The authorized administrative officer gave permission.
Conflict of Interest
The authors declare no competing interests.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Elnaim, A.L.K., Osheik, M.M.A., Ahmed, A.A.O.M. et al. Day of Surgery Admission (DOSA): Thirteen Years’ Experience in a Resource-Limited Hospital in East Sudan-Kassala. Indian J Surg (2024). https://doi.org/10.1007/s12262-024-04051-8
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s12262-024-04051-8