Monitoring emergency and urgent surgery: an improvement in a Healthcare Management Unit at a third-level hospital in Italy.

Abstract

Introduction: At San Martino IRCCS Hospital in Genoa, Italy, emergency and urgent surgery is classified according to the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) classification, whereby cases are divided into two categories and colour-coded accordingly: - EMERGENCY - (Colour-code: RED) "Surgery to be performed within minutes"; - URGENCY - (colour-code: YELLOW) "Surgery to be performed within hours". In this context, it is essential that the emergency surgical team gets clear and complete information from the proposing surgeon, in order to complete the surgical list.

Methods: Between 14^th April 2023 and 23^th July 2023, a new method of requesting urgent and emergency surgery by filling out an online form was tested.

Results: A total of 406 online requests were made, resulting in 367 E/U surgeries. The greatest number of emergency operations concerned thoracic-abdominal surgery (45%), followed by urology (19%). The requests analysed classified 18% of cases as red and 71% as yellow. The remaining 11% contained compilation errors. Moreover, 11% of the interventions were not performed within the time limits defined according to the severity code.

Conclusions: By means of this new tool, San Martino IRCCS Hospital's Healthcare Management Unit can monitor requests for surgery in real time, thereby achieving greater efficiency and implementing corrective measures in the use of Operating Room resources.