[High resolution surgery: one more step in out-patient surgery]. / Cirugía de alta resolución: un paso más en la cirugía ambulatoria.

OBJECTIVES: One stop surgery (CAR: Cirugía Alta Resolución) is a step forward in outpatient surgery. The new scheme simplifies ambulatory conventional surgery, achieves more satisfaction between patients and optimizes health resources. METHODS: By One stop surgery we mean the performance in the same day of both pre-surgery assessment and surgical procedure. This new working way allows performing a surgical procedure in only one visit to the hospital, instead of the average four visits used before for surgical outpatients. Diagnosis, presurgery assessment and post surgery progress are made by the primary care paediatricians at theirs NHS offices. It is essential to maintain a close relationship between the Paediatric surgeons, the primary care paediatricians as well as with paediatric anaesthesiologists and nurses. An autoevaluation is made once a year in which quality survey results are made public and possible areas for improvement are identified, following the model proposed by the European Foundation for Quality Management (EFQM). RESULTS: We present 416 children treated following this scheme since 2008. Surgery is performed on the abdominal wall, genitals, skin and soft tissues. Families are satisfied with the quality of the whole medical and nursery received care as they qualified it with a 99% satisfaction index. Complications developed in less than 3%. CONCLUSIONS: One stop surgery is a progress in the outpatient surgery and, for us, it is a consolidated, continuously growing and constantly improving scheme of providing medical care.

Cirugía de alta resolución: un paso más en la cirugía Ambulatoria / High resolution surgery: one more step in out-patient surgery

Objetivos. La cirugía de alta resolución (CAR) es un avance más de la cirugía ambulatoria. Esta forma de trabajo logra simplificar la cirugía ambulatoria, consiguiendo una mayor satisfacción por parte del paciente y una optimización de los recursos sanitarios. Métodos. La CAR se define por la realización de la evaluación preoperatoria y la subsiguiente intervención quirúrgica en una única visita hospitalaria. Este nuevo plan de trabajo permite pasar de 4 visitas hospitalarias en la cirugía ambulatoria habitual, a una única visita. El pediatra de Atención Primaria (PAP) en el centro de salud realiza el diagnóstico y la evaluación postoperatoria. Es esencial una estrecha relación entre el cirujano y el PAP así como la formación de un equipo multidisciplinar integrado por cirujanos, anestesistas y enfermería. Anualmente se realiza una autoevaluación, se publican los resultados de las encuestas de calidad obtenidas y se identifican áreas de mejora, siguiendo el modelo de excelencia europea propuesto por la European Foundation for Quality Management (EFQM).Resultados. Presentamos una serie con 416 pacientes intervenidos mediante este sistema, desde 2008. Las intervenciones que se realizan son cirugía de pared abdominal, cirugía genital, cirugía de piel y partes blandas. La valoración global de la asistencia recibida por parte de los (..) (AU)

Objectives. One stop surgery (CAR: Cirugía Alta Resolución) is a step forward in outpatient surgery. The new scheme simplifies ambulatory conventional surgery, achieves more satisfaction between patient sand optimizes health resources. Methods. By One stop surgery we mean the performance in the same day of both pre-surgery assessment and surgical procedure. This new working way allows performing a surgical procedure in only one visit to the hospital, instead of the average four visits used before for surgical outpatients. Diagnosis, presurgery assessment and post surgery progress are made by the primary care paediatricians at theirs NHS offices. It is essential to maintain a close relationship betweenthe Paediatric surgeons, the primary care paediatricians as well as with paediatric anaesthesiologists and nurses. An autoevaluation is made once a year in which quality survey results are made public and possible areas for improvement are identified, following the model proposed by the European Foundation for Quality Management (EFQM).Results. We present 416 children treated following this scheme since 2008. Surgery is performed on the abdominal wall, genitals, skin and soft tissues. Families are satisfied with the quality of the whole medical and nursery received care as they qualified it with a 99% satisfaction index. Complications developed in less than 3%.Conclusions. One stop surgery is a progress in the outpatient surgery (..) (AU)