Haddock G, O'Toole S J, Raine P A, Davis C, Walker G M
Department of Paediatric Surgery, Royal Hospital for Sick Children, Yorkhill NHS Trust, Yorkhill, Glasgow.
Health Bull (Edinb). 2001 Mar;59(2):77-80.
Two recommendations of NCEPOD were the introduction of dedicated emergency theatres and a higher level of consultant involvement in emergency cases. In May 1998 a dedicated emergency theatre was introduced in the Royal Hospital for Sick Children, Glasgow. At the same time the on-call rota of the Consultant Paediatric Surgeons was changed from days on-call to a period of one week, during which elective commitments were cancelled.
A retrospective audit was conducted for the 12-month periods before and after these changes. Start times of emergency cases and grades of surgeons were obtained from the theatre database.
The proportion of emergency operations carried out during on call periods (weekends and weekdays after 5 pm) decreased for general paediatric and neonatal surgery (OR = 0.7, p < 0.01). There was an increase in the proportion of daytime emergency cases performed before 1 pm (OR = 0.28, p < 0.01). The Consultant Paediatric Surgeons were involved in more emergency cases (OR = 0.60, p < 0.01).
The provision of a dedicated emergency theatre increased the proportion of emergency cases performed during normal working hours, particularly before 1 pm. Cancelling elective commitments for Consultant Paediatric Surgeons ensured higher levels of consultant input into daytime emergency cases.
国家儿童急救医疗审计项目（NCEPOD）的两项建议是设立专门的急诊手术室以及提高会诊医生参与急诊病例的程度。1998年5月，格拉斯哥皇家儿童医院设立了专门的急诊手术室。与此同时，小儿外科会诊医生的值班轮班制度从按日值班改为为期一周的值班制度，在此期间取消了择期手术安排。
对这些改变前后的12个月时间段进行回顾性审计。从手术室数据库获取急诊病例的开始时间和外科医生级别。
普通儿科和新生儿外科在值班期间（周末及工作日下午5点之后）进行的急诊手术比例下降（比值比=0.7，p<0.01）。下午1点之前进行的日间急诊病例比例有所增加（比值比=0.28，p<0.01）。小儿外科会诊医生参与的急诊病例更多（比值比=0.60，p<0.01）。
设立专门的急诊手术室增加了正常工作时间内，尤其是下午1点之前进行的急诊病例比例。取消小儿外科会诊医生的择期手术安排确保了会诊医生对日间急诊病例投入更高的精力。
