Masood Jawaid, Muhammad Farhan Amin, Rehan Abbas Khan, Syed Abdullah Iqbal.
An audit of reduction in waiting times for emergency surgeries in a tertiary care teaching hospital.
Pak J Med Sci Jan ;21(4):422-5.

Objective: To estimate the waiting times for emergency surgeries after implementing recommended guidelines in a tertiary care public hospital to close the audit loop. Settings: Surgical Unit IV, Civil Hospital Karachi. Design: Descriptive comparative study. Patients and Methods: Patients admitted through emergency for immediate surgery were included in the study. Guidelines previously prepared to reduce waiting time were implemented. A proforma was made to collect information like diagnosis, operation performed, time of planning immediate surgery, time of actual surgery, factors responsible for delay apart from demographic data. Main outcome measures: Waiting times for emergency surgery, different causes responsible for the delay. Comparison of waiting times with the previous study. Results: A total of 40 patients were enrolled in the audit study. Seventeen (42.5%) patients had to wait for more than 3 hours for surgical procedure as compared to 73.3% in the previous study. In this study 15% waited for 4 hours, 20% for 6 hours and only one patient waited for more than 12 hours. In the previous study 17.7% waited for 4 hours, 33.3% for 6 hours and 6.6% of patients waited for more than 12 hours. Most of the delays were due to timing of admission (29.4%) and time taken to arrange blood (29.4%) followed by investigations in 23.6%. Previous study before implementing guidelines reported 33.3% delays due to doctors not performing their duty at the earliest followed by admission timing in 21.2%. Unavoidable causes were responsible for 17.6% of delayed surgeries. Conclusion: The findings of the study showed that recommendations were implemented successfully and the outcome was encouraging, compelling the authorities to continue with the same plan to reduce the percentage of delays even further. During a meeting to present the results of this audit, all the staff was made aware of this encouraging improvement.

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