Quality improvement tools to support implementation
Implementing new day surgery pathways requires continuous review and evaluation to ensure change improvement is achieved and sustained.
Measurement for quality improvement, benchmarking and reporting should be embedded in the perioperative process.
Safer Care Victoria has a step-by-step guide to using the Model for Improvement as the framework to guide improvement work.
The Clinical Excellence Commission in NSW also provides a range of tools and resources to help design, measure and evaluate your work.
Linking with other champion health services for mentoring support during the implementation phase can also ensure the success and sustainability of safe day surgery models.
Measuring clinical and non-clinical outcomes
Monitoring safety and quality indicators related to day surgery performance will help promote safe expansion of day surgery.
Measure | Definition | Rationale |
|---|---|---|
Unplanned admissions (planned day surgery cases) | Number of patients planned as day cases who require overnight bed | To monitor the unforeseen need for hospital beds for planned day cases. Helps to measure effective patient selection for day surgery. |
Unplanned readmission | Readmission within 48 hours and 28 days post discharge from surgical admission | Quality and safety measure. To monitor for unforeseen complications. |
Representations to emergency department | Representations to the emergency department within 30 days of procedure and reason for presenting | Quality and safety measure. To monitor for re-distribution of patients from one part of the system to another. |
Mortality | Mortality at 30, 90 days and 12 months | Quality and safety measure. |
Hospital-acquired complications (HAC) | As per national HAC definitions | Quality and safety measure. |
Major medical complications | Major medical complications within 30 days (stroke, myocardial infarct, and pulmonary embolism) | Quality and safety measure. |
Patient experience | Patient survey to capture feedback on patient experience | To evaluate how the changes have affected the patient’s experience. |
Proportion of potential day procedures performed as day procedures in patients with suitable selection criteria (e.g. ASA 1 and 2) reported by health service/campus. | Number of patients who meet selection criteria to receive day surgery for the targeted procedure | To allow comparison between suitable patients and the number of day cases being performed. |
Number of day cases performed for each targeted procedure | Number of day cases performed | To monitor the number of patients receiving day surgery. |
Reviewed 08 May 2024