We are all getting the message that we are the folk who can facilitate early discharge if only we don't cause pain/fainting/sickness and the rest, and many of us are trying out or revisiting techniques that can get the patients out of hospital sooner, we have tried them all here and are having another go round the trees, but we think that a few more physios (many unemployed after qualifying) and combating the nurses need to fail to get drains out and to shove patients back into bed at the slightest hitch may be critical to any developments we may make.
When we lead the way in this area we have to be a bit more active in assuming control over the process and not just sign it off as the patients leave recovery, However, this isn't so easy when we are being asked to be in theatre for more sessions each week. Make time in your job plan for next year. Each department needs a zealot who can take up the cause, (or to show it doesn't work). We think it can, even without changing anaesthetic practice, and maybe more if we try hard with disposable LA infusions, active management of perioperative blood volume and enthusiastic ward staff.