865 Reducing Delays in Cholecystectomy Surgery of Patients Admitted with Gallstone-Related Disease Within Gold Standard Time Frame Set Out By NICE

Abstract Introduction As per NICE guidelines, Cholecystectomy Quality Improvement Collaborative (Chole-QuIC) aims for 80% of eligible patients with gallstone-related disease to receive their cholecystectomy within 8 days presentation1. Only 63.6% at East Lancashire Hospitals NHS Trust (ELHT) had surgery the target time. This project was done identify reasons behind ELHT not achieving set and implement changes overcome this. Method a retrospective review prospectively collected data 444 from Chole-QuIC database (July 2019-November 2020). Data were analysed in three periods: initial period 2019), pre-COVID-19 (December 2019-February 2020), COVID-19 (March 2020-November Time established. If 8-day met, delay recorded. Results During first cycle, main delays included being temporarily unfit (13.8%), insufficient theatre capacity (13.8%) variations treatment plans (11.32%). 8% re-admissions related gallstone disease. Changes implemented forward clear local management pathway CholeQuIC referral system, increasing capacity, allocating pre-operative assessment slots. Gold standard improved 67.4% months changes. However, figure drastically reduced during pandemic (36.3%) as elective surgeries suspended. Conclusions The implementation pathway, coordinated system additional contributed increase cholecystectomies that performed national period.