Increasing value: The King's College Hospital Experience

Toby Colegate-Stone, Adel Tavokkolizadeh, John Moxham, Joydeep Sinha

British Journal of Healthcare ManagementVol. 22, No. 6

Published Online:21 Jun 2016. https://doi.org/10.12968/bjhc.2016.22.6.326

Abstract

The increasing trauma demands imposed by our population require innovative practice. A day surgery trauma service is a pragmatic response for those patients with less severe, more ambulatory trauma, and whose surgery has a lower risk profile. By using the principles set out in the value-based healthcare (VBHC) agenda, such a re-orientation of service offers opportunities in improving outcomes and reducing costs, this study assessed the impact of the day surgery trauma service in its current activity, the outcomes generated, its potential development and its fiscal footprint. The average patient satisfaction was very good with 92% preferring their surgery performed as day surgery rather than as an inpatient. Day surgery was noted to have a higher run rate of cases per unit of time, lower costs and subsequently a better margin generation per minute. The additional annual profit generated by performing a single whole day trauma list in day surgery was approximately £293 000. By focusing on the needs of the patients and placing them at the centre of service re-design constructive change is seen to be possible. The day surgery trauma service can be shown to deliver higher value care. Triaging the locus of surgery in this way helps to get patients to the best place for the best outcome.