title: '23 h Model' for breast surgery: an early experience.
abstract: The principles of fast track surgery are well established in colorectal surgery. It is an evidence based model aimed at reducing length of stay, convalescence and morbidity by optimising both clinical and organisational factors. Despite this, the implementation of fast track surgery in breast cancer patients has been slow. The 23 h discharge model for breast cancer surgery patients has been outlined by the NHS Improvement Programme and is a breakthrough from traditional inpatient care. This paper outlines the early experience of implementation of this model in a single institution during a 3-month audit period. Over 80% of patients undergoing non-reconstructive breast surgery were discharged safely within '23 h'. This suggests that good communication links, reorganisation of existing resources, active user involvement (both patients and clinical team) and strong project management ensures fast-tracking to be safe for the patient with significant economic benefits for the hospital.
authors.affiliation: The Rose Centre, St George's Hospital NHS Trust, Blackshaw Road, Tooting, London SW17 0QT, UK. Electronic address: allyhainsworth@googlemail.com.
authors.forename: A J
authors.initials: AJ
authors.lastname: Hainsworth
authors.forename: C R
authors.initials: CR
authors.lastname: Lobo
authors.forename: P
authors.initials: P
authors.lastname: Williams
authors.forename: C
authors.initials: C
authors.lastname: Case
authors.forename: F
authors.initials: F
authors.lastname: Surridge
authors.forename: A K
authors.initials: AK
authors.lastname: Sharma
authors.forename: D
authors.initials: D
authors.lastname: Banerjee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000191:economics* / Q000601:surgery*; D002985:Clinical Protocols; D004322:Drainage; D005260:Female; D017721:Hospital Costs; D006801:Humans; D007902:Length of Stay / Q000191:economics; D008408:Mastectomy / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D008875:Middle Aged; D010351:Patient Discharge; D013997:Time Factors; D055815:Young Adult
keywords: Ambulatory; Breast surgery; Fast track