In February 2025, Dr Vipul Kaushik, day case lead anaesthetist worked with the breast surgery team on a project that made breast surgery safer and faster for patients.
Together with Emma Cross, transformation lead, they noticed that many patients having a simple mastectomy, a type of surgery that removes all their breast tissue, were staying in the hospital overnight, even though they could go home the same day. There was no standard process, patients were often scheduled later in the day, and many who were meant to go home ended up staying. By mapping out the whole process, she could see where changes were needed.
Working with anaesthetists, pre-operative colleagues, surgeons, and ward teams, Vipul and Emma highlighted several areas for improvements, including:
- giving staff better access to data to track progress
- changing anaesthetics to reduce side effects after surgery
- creating clear steps for listing patients and preparing them for surgery
- scheduling day cases earlier in the day
- providing consistent information so patients knew they could go home the same day
- teaching patients about drainage care after surgery
- checking in with patients after discharge using text messages
These changes had a startling impact. The number of patients going home the same day after a simple mastectomy rose from 10% in November 2023 to 65% by September 2024, with even higher numbers expected in the future.
Dr Vipul Kaushik said: “In today’s climate, many patients wait months or years for surgery, so we focus on thorough preparation to prevent cancellations. We provide clear information, ensure they understand their care, and help optimise health by reducing smoking and drinking and improving fitness.
“Using evidence-based practice, we aim for safe same-day discharge so patients can recover comfortably at home. Modern techniques support early eating and drinking, strong pain control, minimal nausea, and prompt mobilisation to enhance recovery. This approach ensures safer care and better overall outcomes.”
This project is part of myQI: your care – our campaign that shines a light on the everyday improvements our teams are making across UHL for the benefit of our patients.
The myQI campaign shares stories from our teams who have spotted opportunities to make things better and acted on them – bringing real benefits to patients, as well as the colleagues who care for them.