PFC 2005 - Pre-operative

Page contents: Aim | Change concepts | Key Change Principles | Measures | Resources | Toolkits | Training | Websites and links

Aim

Provide effective pre-operative assessment for patients who require elective/emergency surgery

Change Concepts

• Establish pre-operative service to assess patient at the clinical decision to operate
  • Short assessment in out patients
    • By a questionnaire
    • Any patient who is not fit for operation should be given a treatment plan before they are placed on an active waiting list
  • Telephone pre-operative assessment should be used for all patients who need hospitalisation or have a clinical condition prompting assessment
  • Protocol driven pre-operative care via GP
• Increase nurse lead pre-operative service
• Develop protocols for standardised pre-operative assessment and training of nurses and junior medical staff
• Agree Anaesthetic support for pre-operative clinic
• Develop first stage assessment within Outpatient Department via outpatient nursing staff
• Develop information for day case, inpatient and 23 hour stay patients
• Agree care pathways for patients who are not fit for their operation in the community
• Manage patients on waiting list: maintain fitness via exercise, diet, smoking, etc

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Key Change Principles

Establish pre operative assessment as a safety and quality initiative in the stage of the process that assists the patient to receive care.

Measures

• Capacity and Demand
  • Existing Capacity v Utilisation v Number Waiting
• Did not Attend (DNA) rates per day/week
• Postponements by reason - e.g. No Bed, No ICU/CCU Bed, Surgeon Unavailable.

Resources

Booking Patients for Admission (14kb, pdf)

Pre op Tests and End Users (114kb, pdf)

Routine Pre op Testing (372kb, pdf)

Web Based Education (99kb, pdf)

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Toolkits

• Pre-operative care (435kb, MS Powerpoint)
• Process mapping
• Understanding data
• Redesign methodology

Training

• Capacity and demand
• Streaming
• Ready - steady - book
• Nurse lead pre-op questionnaire/assessment

Websites and Links

OMNI UK; Preoperative Care

BBC News Online; Pre-operative care

SIGN UK; Pre-operative Care

OMNI UK; Day Care

Greenwich Hospital; Medical services

ARCHI; Enhancing Ambulatory Care Services (Royal Darwin Hospital) (membership required)

Looksmart; Ingredients for a successful pediatric preoperative care process - Clinical Innovations

Mississippi Medical Centre; Satellite Approach Augments Preoperative Patient Care

BMJ Journal Articles

ARCHI; Outpatients (membership required)

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