Authors (including presenting author) :
Lau SY (1), Wu PH (1), Lai TH (1)
Affiliation :
(1) Day Surgery Unit, Alice Ho Miu Ling Nethersole Hospital
Keyword 1: :
High-volume surgical service
Keyword 4: :
Day Procedure Setting
Keyword 5: :
Day Surgery Unit
Introduction :
Report in 2020 showed over 50% of men were affecting by BPH and there will be an increasing prevalence that man to be suffered. A minimally invasive surgical therapy treatment was introduced at Day Surgery Unit (DSU) of Alice Ho Miu Ling Nethersole Hospital to tackle the increasing demand. A non-operating theatre dependent procedure performed in a treatment procedure room at DSU produced a 4 times faster procedure that patient's long waiting for traditional operation (TURP) can be reduced from 2 years to 2 months. In addition to the result of this high-volume surgical procedure can cater for higher capacity of case load, it showed patient can regain better urination function in a far shorter period of time. A comprehensive case management nurse-led service model facilitates and monitor the patient pathway so as to attain better quality of life for patient suffered from BPH.
Objectives :
I)Shorten patient's care journey by reducing patient waiting times and alleviating hospital bed occupancy pressures through the new one-stop Nurse-led service. II)To ensure optimal quality and safety through collaboration with Infection Control, Supplies, and Administration.
Methodology :
The treatment room was adapted to perform local-anesthesia procedures. A nurse manager–led model was implemented and proved efficient: nurses acted as primary case managers, coordinating logistics, monitoring patients perioperatively, and tracking outcomes. In the traditional BPH surgery pathway, patients often face long urology clinic waits, delayed TURP decisions, repeated A&E visits for catheter problems, hospital stays >2 days, and multiple follow-ups, with total treatment taking up to 2 years. In the nurse manager–led pathway, urologists promptly refer patients to the AHNH nurse clinic. Nurses provide continence care (bladder training, Foley care, incontinence support), pre-MIST education, and complete MIST within a half-day to reduce hospitalization and delays. Post-op reviews at the nurse clinic cover investigations, pathology, blood results, and voiding issues, supported by holistic TLC, skills, logistics optimization, and close care-path monitoring.
Result & Outcome :
A total of 369 patients have successfully undergone surgery at the Day Surgery Unit (DSU) in AHNH, which operates exclusively as a day procedure setting for trial from 1/11/2022 to 31/12/2025. Implementing Minimally Invasive Surgical Treatment (MIST) in the Day Surgery Unit (DSU) treatment room relieved operating theatre pressure, enabling more complex urology procedures to be performed in theatre. Procedure time improved markedly: early trial cases took ~1–1.5 hours, but this was reduced to ~30 minutes per case (about a fourfold efficiency gain). The service has treated >400 cases, demonstrating high throughput and effective resource use. Patient outcomes also improved: for catheterized BPH patients, time from urology outpatient referral to treatment fell from 24 months to 2 months. For catheterized patients eligible for surgery within two months, the commitment rate increased to >65% (vs 39% before introduction of MIST programme). Patient satisfaction increased due to faster recovery and fewer post-procedure complications.
