Extended Recovery Facilities

Definitions
True Ambulatory Surgery

This is where patients are admitted, operated on and discharged during the time frame of one working day (6 to 8 hours). There is no overnight stay.

Ambulatory Surgery with Extended Recovery

This is where patients are admitted, operated on and stay for one night post-operatively in a hospital facility (overall stay up to 23 hours).

Types of extended recovery

Ward

This is to the design of an inpatient ward, is fully nursed and has doctors' rounds.

Hospital Hotel

This is to the design of a 2 to 3 star hotel. Patients are cared for by staff who are not nurses, but have the attributes of a good and caring relative. There are no doctors' rounds.

Why extended recovery developed

Ward

Initially in the private sector by freestanding day units to increase their range of surgery and boost their income.
In public healthcare systems to meet government " day surgery" targets without increasing true day surgery.

Hospital Hotel

To allow those living alone to have day surgery and recover in non-clinical surroundings with surrogate relatives.

Advantages extended recovery

Ward

Extends patient base for private freestanding day units thus maximising return on investment.

Hospital Hotel

Disadvantages extended recovery

Ward

Cost per night at least the same as a normal inpatient ward.
Has the same management and organisation as an inpatient ward.
Staffing costs may be higher than normal inpatient ward if there are not the maximum number of beds for the minimum nursing levels eg: at night 2 nurses are a minimum requirement and they can care for 20 patients.
Reduces the pool size and flexibility of usage of inpatient beds. (If 23-hour wards are sensible then there should also be 48-hour, 72-hour, 96-hour, etc wards. Clearly this is unmanageable) .
Introduction may delay the development of true day surgery or even reverse move to day surgery.

Hospital Hotel