The deferrable elective patient: a means of reducing waiting-lists in orthopaedics

Abstract

The orthopaedic trauma session is almost universally adopted as a means of coping with non-elective orthopaedic demand. Here patients who can be stabilised are treated in a weekday planned theatre session. It allows for greater consultant involvement and a reduction in out-of-hours operating. The utilisation of trauma theatre time is typically low. However, there is an opportunity to make better use of this time by including some "deferrable elective patients" in the session. These are elective patients who have been offered earlier treatment in return for accepting the possibility of postponement, if the trauma demand on the day of the appointment is high. Simulation of patient demand was used to explore the balance between maximising the utilisation of the theatre sessions, avoiding too many overruns and ensuring a reasonable quality of care in a typical hospital in the UK.