Most surgery candidates are admitted as patients and prepared in the pre-operative patient care area. About half are discharged on the same day of their surgery.

The facilities at the Royal Children's Hospital include 14 operating theatres, two patient recovery areas and the Central Sterilising Services Department (CSSD) which features the latest equipment and facilities for washing and re-sterilising all reusable patient care equipment and instruments. 

Key features

• Theatres are nominated to specialties, however any procedure can be done in any theatre with exception of endoscopy, which is a dedicated theatre.
• A 24/7 service operates for emergency trauma surgery.
• Before surgery, all patients are seen by a nurse, anesthetist and the surgeon for preoperative checks.
• Except for urgent trauma cases, all patients go to pre-operative care for final checking before theatre.
• All patients go to Stage 1 Recovery following surgery, with the exception of patients going directly to ICU.

In Stage 1 Recovery patients are monitored until they are awake and breathing normally.  At that point they can be moved to Stage 2 Recovery (Day Surgery), inpatient ward or possibly the intensive care wards (Rosella/Butterfly). Only patients who need to be placed in intensive care immediately after surgery bypass Stage 1 Recovery.  

Stage 2 Recovery is for day surgery patients who are admitted and discharged home on the same day (approximately half of our surgery patients). These patients may remain in Stage 2 Recovery from just 30 minutes to several hours, until they are assessed as fit to go home. However, sometimes patients may be transferred from Stage 2 Recovery to an inpatient ward, if their condition requires.

There are five 'pathways' for surgery patients at The Royal Children's Hospital: 

Day Stay

Patients are admitted to hospital on the day of their surgery via Reception J - Surgery, cared for in the pre-operative area, undergo their surgery, pass through Stage 1 and Stage 2 Recovery, and are discharged the same day.

Day Surgery admission to Inpatient ward

Patients are admitted to hospital on the day of surgery directly to Surgery via Reception J - Surgery and cared for in the pre-operative area. They are moved to theatre for their surgery and then monitored in Stage 1 Recovery until awake. After surgery, they pass through Stage 1 Recovery and move to an inpatient ward, where they may remain overnight of for a few days. 

Inpatients

Patients are already admitted to hospital and transfer from an inpatient ward or Emergency straight to the pre-operative preparation area and into the operating theatre. Following surgery, they may go to:

• Rosella - Paediatric Intensive Care Unit or Butterfly- Neonatal Intensive Care Unit
  
• Stage 1 Recovery then to an inpatient ward
  
• Stage 1 Recovery then Stage 2 Recovery (Day Surgery) if going home the same day

Rosella/Butterfly

Intensive Care patients go directly to the operating theatre and then usually return straight to Rosella - Intensive Care after surgery.

Urgent trauma

Patients arriving at the hospital requiring urgent surgery will go directly to the operating theatre and bypass the pre-operative area. After surgery, they are usually transferred straight to Rosella - Intensive Care. If their condition is stable, the patient will pass through Stage 1 Recovery and move to an inpatient ward.