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9. The patient would be managed with the help of a multidisciplinary team if
needed with the appropriate subspecialty referral given. 10.
The patients would be discharged with a discharge note to be kept with the patient including details of medication, treatment and new appointment
dates, copy of which will be in the notes. 11.
The BHT of the patients will be dispatched to the record office within 72 hours of discharge.
12. The decision to discharge is only made by a specialist.
13. In cases of emergency surgical procedures, it would be done within 6hours
from the time of admission. 14.
In cases of elective surgical procedures, it would be done within 3 months from the date of diagnosis, except for oncology cases.
15. All medications, including benefits and side effects would be explained to the
patient.
Measurable elements of 12.1
1. Time taken from admission until review by doctor 20 minutes
2. All cases to be seen and managed by specialist at least once during admission
daily 3.
Discharge summary of patients to be completed within 72 hours 4.
Elective cases admitted should have a plan of management written.
The standard for all the above measurable elements shall be 100
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13.0 GYNAECOLOGY OPERATION THEATRE
Standards
13.1 Cases posted for elective gynaecology operation theatre.
Intent of 13.1
1. All cases are seen by a medical officer or specialist in the gynaecology clinic
and decision for operation is made by specialist. 2.
A temporary date is given after discussion with patient and entered in the OT book based on the appropriate subspecialty.
3. Operation list is made after the patients are fully investigated. example CT
scan 4.
Weekly pre-op discussions are held and the cases are discussed in detail. They are either planned to be reviewed, re-examined or an operation date is
confirmed or pre or post posted according to priority. 5.
Patients are informed to come for review and for those who are planned for operation; an admission form is given to them. Anaesthetic assessment forms
are also given to all high risk cases prior to being discussed and put on the OT list.
6. The waiting time for elective cases from time of diagnosis to operation is less
than 6 months. 7.
All operations are performed by specialists or OT supervised by specialist. 8.
The patient in counselled regarding the indication, the procedure and complications by the specialist.
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9. The relatives are also informed and updated regarding the nature and
complications of the procedure. 10.
Informed written consent is taken from the patient prior to surgery. 11.
All cases are seen by anaesthetist prior to surgery. 12.
All investigations are taken and reviewed by the attending doctor and if necessary, blood is grouped and cross matched.
13. Selected complicated patients will be required to undergo bowel preparation.
14. Pre operative assessment is done by the operating surgeon prior to the
operation.
Measurable elements of 13.1
1. Waiting time from diagnosis to operation.
2. Preoperative decision made by specialist.
3. Written high risk consent from patients.
4. Number of high risk cases seen by anaesthetist.
5. Number of cases cancelled by anaesthetist.
6. Operative complications, ureteric, bladder and bowel injury and unplanned
return of patient to operation theatre- incident report
Evidence of continuous monitoring of above standards and remediable actions taken Std: 100
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