Day of Surgery Admission (DOSA): Thirteen Years’ Experience in a Resource-Limited Hospital in East Sudan-Kassala

With the growing need for health services, proper bed capacity management is mandatory to avoid patient rejection or cancellation of a procedure. Hence, the day of surgery admission (DOSA) protocol is gaining popularity with safety concerns. We conducted this study in a 120-bed hospital. Our unit has four operating lists per week for elective cases. All patients who planned for elective surgery, with no medical illness or who had a controlled medical illness, were recruited. Every patient was seen in the surgical clinic with his plan of management written in his admission paper. Patients were admitted from 07:00 to 11:00 am through the special admission counter. We evaluated hospital stay, postoperative complications, and mortality. The total number of patients was 18,500 in a 13-year duration. The total number of case cancellations was 396 patients (2.1%). The general surgical procedures were 6987 (38%), the GIT procedures were 5469 (30%), the endocrine and breast procedures were 3545 (18%), the pediatric surgery procedures were 1431(8%), while urology procedures were 1068 (6%). The hospital stay was 1 day or less in 10,305 (56%) patients. The total number of patients who developed postoperative complications was 491 (2.6%). The mortality rate was 0.05% (10 patients). DOSA is a valid and safe protocol for selected patients. It minimizes hospital stays, reducing expenses. Adoption of DOSA will increase bed availability and avoid case cancellation.