The use and impact of a daily general surgical emergency operating list in a district general hospital: a prospective study.

Daytime emergency operating lists (EOL) have been shown to reduce out-of-hours operating but problems with their introduction have been reported. A six-month prospective study of EOL and unscheduled operations (USO) was undertaken. Two firms use their EOL differently--one including mostly emergencies, the other including a number of urgent elective cases. After the introduction of EOL only 9 per cent of emergency operations were performed after midnight. Including urgent elective cases on the EOL allowed full use of available theatre time but meant that proportionately more emergency operations were unscheduled. A senior surgeon was involved with 75 per cent of EOL and 36 per cent of USO operations, and a senior anaesthetist with 52 per cent of EOL and 14 per cent of USO. Senior anaesthetic involvement would have been greater if there were more senior staff. There had been a marked increase in the number of USO over the four years previous to this study. EOL do reduce out-of-hours operating and allow excellent supervision and therefore training opportunities. Care must be taken with the case mix to balance full use of theatre time with reduction in out-of-hours operating.