title: Hand and wrist surgery: study of efficacy about a new way for one-day low-complexity surgery.
abstract: BACKGROUND
  In our Hand Micro-surgery Department surgery procedures identified by some regional legislation as "low-complexity care interventions" (BOCA) are carry out. For this reason, as pilot experience, it has been decided to apply Diagnostic Therapeutic Path (DTP) to this type of surgeries in order to improve the offered service.
  
  
  METHODS
  From 2011 to 2012 we collected data about 410 BOCA procedures and we monitored a series of indicators.
  
  
  RESULTS
  The patients were classified as ASA score 1-2 (99%) and they had a postoperative observation time less than 24h (95%). They reported a constant reduction of pain in the days after surgery (VAS ≤ 4). In 27 cases were found post-surgical complications. All patients evaluated positively this DTP.
  
  
  CONCLUSIONS
  The obtained results were used to improve the activity in others Departments of our Institute.
authors.affiliation: Orthopedic Institute G. Pini, Milan, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Navone
authors.affiliation: Orthopedic Institute G. Pini, Milan, Italy.
authors.forename: F M
authors.initials: FM
authors.lastname: Uboldi
authors.affiliation: Post graduate School in Public Health, University of Milan, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Domeniconi
authors.affiliation: Orthopedic Institute G. Pini, Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Conti
authors.affiliation: Post graduate School in Public Health, University of Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Piscitelli
authors.affiliation: Orthopedic Institute G. Pini, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Nobile
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures / Q000379:methods; D001182:Arthroscopy / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006225:Hand / Q000473:pathology / Q000601:surgery*; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016896:Treatment Outcome; D014955:Wrist Joint / Q000473:pathology / Q000601:surgery*
keywords: Diagnostic process; Low complexity surgery; Outpatient surgery; Quality system; Therapeutic process