Author: Jason Curtis

Medicine Flow Team – Test of Change RSH (2025)

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Type of publication:

Service improvement case study

Author(s):

*Shelbey Fenton-Cook

Citation:

SaTH Improvement Hub, December 2025

SMART Aim:

During a 1-month test of change 22nd Sept – 17th October 2025

  • Reduction in simple LOS to trust target of 4 days
  • Increase pre 12:00 discharges to trust target of 35%
  • Increase pre 08:45 transfers to DCL to 10%
  • Increase in DCL utilisation to 50%

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SaTH and CTH Therapy Weekend assessment and Discharge Model (2025)

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Type of publication:

Service improvement case study

Author(s):

*Mandy Taylor; *Sharon Huckerby; *Sarah Robinson.

Citation:

SaTH Improvement Hub, December 2025

SMART Aim:

To develop a streamlined therapy approach to support the discharge of the complex patient ensuring the patient is supported to leave the acute setting as soon as medically optimised by 20th November 2025 as
evidenced by complex discharge figures.

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Oxygen Prescriptions for Gynaecology Inpatients (2025)

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Type of publication:

Service improvement case study

Author(s):

*William Roberts

Citation:

SaTH Improvement Hub, December 2025

SMART Aim:

Trust policy for all inpatients to have a target oxygen saturation identified on admission. Widespread issue with poor oxygen prescription compliance across the country. 47% (n = 15) of gynae inpatients had no oxygen prescribed. Incorrect/absent prescriptions have the potential to cause harm. Target compliance 80%

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Next-of-Kin (NOK) Communication Bundle – Second Cycle (2025)

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Type of publication:

Service improvement case study

Author(s):

*Yasmin Ahmadi, *Giulia Abdel Latif

Citation:

SaTH Improvement Hub, December 2025

SMART Aim:

To evaluate the awareness, use, and perceived helpfulness of the NOK communication sticker among ward staff following its implementation in Cycle 1 by 31st October 2025 as evidenced by staff feedback survey results.

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The robotic platform is the minimally invasive tool of choice- Improving techniques and outcomes (2024)

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Type of publication:

Conference abstract

Author(s):

Mohamedahmed A.; Abdalla H.E.; *Ismail A.; Yassin N.A.

Citation:

Colorectal Disease. Conference: 19th Scientific and Annual Conference of the European Society of Coloproctology, ESCP 2024. Thessaloniki Greece. 26(Supplement 2) (pp 239), 2024. Date of Publication: 01 Sep 2024.

Abstract:

Aim: This study aimed to assess the clinical outcomes of robotic compared with laparoscopic surgery within a transformation of minimally invasive total surgical practice. Method(s): A series of 201 consecutive patients relating to a single surgeon's experience when transforming total minimal invasive practice from laparoscopic to robotic surgery were included. Patients underwent laparoscopic and robotic surgery between 2018 and 2023. Short-term and long-term outcomes were evaluated and compared between the Laparoscopy (LG) and robotic (RG) with subgroup analyses according to procedure. Result(s): The median age and length of hospital stay (LOS) were 64 years and 6 days, respectively. Indications for surgery were CRC (62.2%), IBD (27.4%) and other general surgery conditions (hernia, appendicectomy, de-functioning loop colostomy, complex diverticular disease and rectal prolapse) (10.4%). The surgical approach was laparoscopic in 62 patients (30.8%) and Robotic in 139 patients (69.2%). Conversion to open was 12.9% in the LG versus 0% in the RG (p = 0.001). Regarding postoperative complications, the RG showed lower rate of overall complications [CD>=2 complications 14.3% in RG versus 16.1% in LG, p = 0.02], paralytic ileus [p = 0.03] and shorter LOS (p = 0.001) in comparison to LG. Moreover, both groups showed no difference in anastomosis leak [RG 1.3% vs LG 0%, p = 0.3], abdominal collection [RG 2.8% vs LG 2.5%, p = 0.5], re-operation [RG 1.4% vs LG 1.6%, p = 0.9], 30-day re-admission [RG 7.9% vs LG 8%, p = 0.9] and 30-day mortality [RG 0.7% vs LG 0%, p = 0.5]. Moreover, the RG remained superior when subgroup analyses were applied for anterior resection (39.3%), Right hemicolectomy (28.4%) and subtotal colectomy (13.4%). Conclusion(s): Robotic colorectal surgery improves clinical and surgical outcomes. This minimally invasive approach is the choice in a total transformation of practice from laparoscopic to robotic surgery, leading to significant reductions in LOS, rapid postoperative recovery, and an earlier return of gut function.

DOI: 10.1111/codi.17125

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Intravenous fluid mismanagement: time for national stewardship and quality improvement (2025)

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Type of publication:

Journal article

Author(s):

Breen, Andrew; *Miller, Ashley; Timmins, Alan; Barton, Greg; Kirk-Bayley, Justin; Peck, Marcus John Edwards; Davis, Huw John; Wilkinson, Jonathan.

Citation:

BMJ Open Quality. 14(4), 2025 Dec 14.

DOI: 10.1136/bmjoq-2025-003503

Link to full-text [open access - no password required]

The Impact of Smoking on Outcomes Following Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-Analysis (2025)

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Type of publication:

Systematic Review

Author(s):

*Ibrahim, Abdelrahman; Al-Musabi, Musab; Kabariti, Rakan; Kempe-Gowda, Swarna; Wade, Roger.

Citation:

Cureus. 17(11):e96765, 2025 Nov.

Abstract:

The influence of smoking on postoperative outcomes following anterior cruciate ligament (ACL) reconstruction is a topic of ongoing scientific discussion and uncertainty. We aimed to conduct a systematic review and meta-analysis to compare the outcomes between smokers and non-smokers undergoing this procedure. We conducted a systematic search of electronic information sources, including MEDLINE, EMBASE, CINAHL, CENTRAL, ClinicalTrials.gov, and bibliographic reference lists. We applied a combination of free-text search and controlled vocabulary search adapted to thesaurus headings, search operators, and limits in each of the above-mentioned databases. Primary outcome parameters included surgical site infections, ACL graft rupture, revision rates, and patient-reported outcome measures (PROMs). We identified 24 comparative studies, including a total of 672,241 patients, of whom 69,113 were in the smoker group and 603,128 were in the non-smoker group. The analysis revealed that smoking was associated with a significantly higher risk of surgical site infections (OR 1.40, P=0.01). Smokers also reported significantly worse PROMs on the International Knee Documentation Committee (IKDC) score (MD -5.38, P<0.00001) and multiple Knee Injury and Osteoarthritis Outcome
Score (KOOS) subscales. There was no statistically significant difference between the two cohorts for ACL graft rupture or all-cause revision rates. Smoking appears to be associated with a higher risk of surgical site infections following ACL reconstruction and is linked to significantly poorer functional PROMs.

DOI: 10.7759/cureus.96765

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Factors associated with conversion from day-case to in-patient elective laparoscopic cholecystectomy surgery across England: an observational study using administrative data (2025)

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Type of publication:

Journal article

Author(s):

*Olagunju, Naomi; *Cheetham, Mark; Savage, Katrein; Briggs, Tim W R; Gray, William K.

Citation:

Surgical Endoscopy.  2025 Dec 18. [epub ahead of print]

Abstract:

PURPOSE: Elective laparoscopic cholecystectomy is increasingly being conducted as a day-case procedure. However, some patients planned for day-case surgery stay in hospital for at least one night. The aim of this study was to identify factors associated with conversion from planned day-case to in-patient management for elective laparoscopic cholecystectomy.

METHODS: This was an exploratory retrospective analysis of observational data from the Hospital Episode Statistics dataset for England. All patients aged >= 17 years undergoing a planned elective day-case laparoscopic cholecystectomy between 1st April 2017 and 31st March 2024 were identified. The exposure of interest was discharge on the day of admission (day-case) or requiring overnight stay. For reporting, providers were aggregated to an Integrated Care Board (ICB) level.

RESULTS: A total of 286,754 elective LCs planned as day-case were identified over the seven-year study period. Of these, 74,957 (26.1%) stayed in hospital for at least one night and were classed as day-case to in-patient stay conversions. In multilevel, multivariable modelling, conversion to in-patient stay was associated with great age (odds ratio (OR) 2.54 for 17-29 vs >= 70 years, p < 0.001), male sex (OR = 1.11, p < 0.001), deprivation (OR 1.14, first vs fifth quintile, p < 0.001), open surgery (46.93, p < 0.001), and low annual surgeon volume (OR 1.73, < 10 vs >= 80 LCs per year, p < 0.001). Comorbidities and post-procedural complications were also strongly associated with conversion. Across the 42 ICBs in England, model-adjusted conversion rates varied from 14.5% to 39.0%, 18 (42.9%) ICBs had conversion rates above the 99.8% control limit.

CONCLUSIONS: Conversion from day-case to in-patient stay was associated with increasing age, male sex, deprivation, open surgery, low surgeon volume, comorbidity and post-procedural complication. Our findings will help surgical team identify patients suitable for day-case laparoscopic cholecystectomy.

DOI: 10.1007/s00464-025-12480-z