121 Optimising Gallstone Management: A Fast-Track Approach from Ambulatory Clinic to Operating Room

Abstract Aim To evaluate the management of patients presenting to SACU with gallstone disease, including assessment against surgical criteria and subsequent theatre booking status. To identify factors contributing to delays in surgical booking. To assess the impact and effectiveness of the implemented SACU Gallbladder Pathway on patient outcomes and service delivery Method A retrospective review (Cycle 1) was conducted to assess booking practices for gallstone patients presenting to SACU. Following this, booking criteria were developed and approved at a governance meeting. The criteria were then implemented and displayed in key clinical areas, including SACU and the doctors' handover room. A second data collection (Cycle 2) was carried out post-implementation to evaluate improvements in patient booking to theatre. Results A comparison between two audit cycles assessing gallstone surgery referrals through SACU revealed notable improvements in patient management. In the second cycle, a higher proportion of patients fitting the surgical criteria were appropriately booked through SACU (54% vs. 21%). Although the number of confirmed gallstone cases remained similar (92 in both cycles), A&E revisits decreased significantly from 117 to 74. Conclusions Patients presenting to SACU with confirmed gallstone disease who meet the criteria for elective laparoscopic cholecystectomy should be booked promptly, ideally within 6 weeks. Our re-audit demonstrated improved booking compliance and a notable reduction in A&E revisits, highlighting the benefits of adhering to established referral pathways. This approach not only enhances patient care and outcomes but also contributes to reduced healthcare utilisation and financial burden.