Overnight-stay patients in a day surgery unit to overcome shortage of inpatient beds

A dedicated 23-h stay list was organised at the Addenbrooke's Hospital day surgery unit for elective cases in oral and maxillofacial surgery of minor or moderate severity that would normally be done as inpatients. The patients were selected by the two consultant oral and maxillofacial surgeons and the operations were done by a consultant surgeon (L.C.) and a consultant anaesthetist. Over a 14 month trial period 137 patients were admitted to our 23-h stay lists. One hundred and twenty seven of whom were operated on and stayed overnight, nine went home the same day, and one patient stayed beyond the 23-h limit as he was admitted to the medical ward after a grand mal seizure. The operations were for neoplastic, traumatic, salivary gland and jaw lesions. The reasons for using the overnight-stay facilities varied from social reasons to the need to monitor the airway. The fact that the theatre slots and overnight beds were guaranteed, and that the admissions were booked at outpatient consultation led to few cancellations by patients. This process reduced the inpatient waiting list and released the main operating theatre for major oral and maxillofacial operation, particularly for cancer.