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A survey of UK peri‐operative medicine: pre‐operative care
Author(s) -
Bougeard A.M.,
Brent A.,
Swart M.,
Snowden C.
Publication year - 2017
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/anae.13934
Subject(s) - medicine , psychological intervention , peri , family medicine , primary care , nursing
Summary The majority of UK hospitals now have a Local Lead for Peri‐operative Medicine (n = 115). They were asked to take part in an online survey to identify provision and practice of pre‐operative assessment and optimisation in the UK . We received 86 completed questionnaires (response rate 75%). Our results demonstrate strengths in provision of shared decision‐making clinics. Fifty‐seven (65%, 95%CI 55.8–75.4%) had clinics for high‐risk surgical patients. However, 80 (93%, 70.2–87.2%) expressed a desire for support and training in shared decision‐making. We asked about management of pre‐operative anaemia, and identified that 69 (80%, 71.5–88.1%) had a screening process for anaemia, with 72% and 68% having access to oral and intravenous iron therapy, respectively. A need for peri‐operative support in managing frailty and cognitive impairment was identified, as few (24%, 6.5–34.5%) respondents indicated that they had access to specific interventions. Respondents were asked to rank their ‘top five’ priority topics in Peri‐operative Medicine from a list of 22. These were: shared decision‐making; peri‐operative team development; frailty screening and its management; postoperative morbidity prediction; and primary care collaboration. We found variation in practice across the UK , and propose to further explore this variation by examining barriers and facilitators to improvement, and highlighting examples of good practice.