Waiting time for emergency surgeries in a tertiary care public hospital - a performance audit

ABSTRACT

To find out the waiting time for emergency surgeries and to identify causes responsible for this delay in a tertiary care public hospital.Settings Surgical Unit IV, Civil Hospital, Karachi.Patients and Patients admitted through emergency for immediate emergency operations during the month of November and December, 2003 were included in the study. For data collection a proforma was made which included diagnosis, operation performed, time of planning immediate surgery, time of surgery, causes responsible for delay apart from demographic information.Main outcome measures: Waiting time for emergency surgeries, different causes responsible for the delay. A total of 45 patients were enrolled in the audit study. Majority of patients 14 [31.1%] were suffering from acute appendicitis. 33 [73.3%] of patients had to wait for more than 3 hours before their emergency surgery. Major cause of this delay in 33.6% of patients was due to surgical team doctor's inefficiency. In 7 [21.2%] patients surgery was delayed due to late night admission and in 6 [18.1%] due to non-availability of cross matched blood. In 5 [15.1%] patients surgery was delayed due to unavoidable causes like busy theatre and arrival of more serious patients. A substantial number of patients needing emergency surgery waited too long for the surgical management. Majority of delays were due to causes which can be addressed to improve the patients care