Project Lead

Dr Tim Chittleborough

Lead partner

Royal Melbourne Hospital

MacHSR Future Leaders Fellowship Program (cohort 1).

COVID-19 resulted in a prolonged period of reduced surgical activity which has increased surgical waitlists. The pandemic is having an ongoing impact on the ability to conduct elective surgery due to reduced inpatient bed availability, reduced staffing and increased emergency surgery.

This project aims to quantify the elective surgical waitlist to identify factors impacting on the timely delivery of care. We will investigate if it is possible to increase efficiency within existing theatre resources and explore initiatives to reduce surgical waitlists.

During this project to address long surgical waitlists it was identified that Royal Melbourne Hospital underutilises day surgery. A study was designed and implemented to identify surgical procedures where evidence showed they could be safely performed as day surgery, and change these procedures to day surgery as default.

With exclusion and discharge criteria in place, the day surgery rates successfully increased from 6/7% (2021/2022) to 41% (March – July 2023) for laparoscopic cholecystectomy and from 9/31% (2021/2022) to 51% (March – July 2023) for inguinal herniorrhaphy. Default day surgery was rolled out for four additional procedures during the fellowship period, with further planned for 2024.

Dr Chittleborough acted as the Clinical/Surgical lead on the project and was supported by Planned Surgery Recovery & Reform Program appointed staff. Activity undertaken during this fellowship has resulted in bed day savings and expedited patient flow. It has also led to the establishment of a day surgery community of practice to share learnings and resources across the West Metro Health Services partnership.