THE IMPORTANCE OF UTILIZING LONG WAITING LIST TIMES TO OPTIMIZE PATIENTS PRIOR TO SURGERY: THE BENEFICIAL EFFECT OF INTRODUCING A PERIOPERATIVE OPTIMIZATION SERVICE

Long waiting list times cause patient deconditioning. Poorly optimised patients have a higher risk of comorbid complications, increased length of stay and poor outcome. In 2022, at Musgrove Park Hospital (MPH) a perioperative steering group was established. A set of workstreams were developed and patients were enrolled from listing for surgery and investigated and treated accorded to guidelines developed and based upon national peri-op guidance. Anaemia : 198 enrolled - 53% of patients screened were found to be anaemic. The median number of patients presenting to POAC with anaemia dropped from 7 to 3. £14K savings in IV iron to date. Diabetes : 101 enrolled. 90% of patients now demonstrating good diabetes management at surgical listing, 74% among those being listed for urgent surgery. Model Health data shows LOS reduction over last 18 months (3.8 to 2.8). Frailty: 32 patients assessed with home visits / MDT review. 11 patients opted for community support over surgery. Post-surgical outcomes tracked with EQ-5DL and decisional regret metrics. Smoking : 43% of listed surgical patients found to be smokers. 400 patients contacted with 162 patients now entering a tobacco reduction pathway. Weight loss : 46% of this same cohort have a BMI of =>30. To date 313 patients have entered a weight management programme. Outcomes to be tested include improvement cardiovascular function, mobility, strength and emotional wellbeing. Establishment of a peri operative service has demonstrated the beneficial effects of surgical patient optimisation and highlighted the importance of early intervention. Nectxt steps include collaboration with primary care to integrate referrals at the earliest stage and align messaging across healthcare touchpoints to promote well-being, patient ownership, and system-wide collaboration.