Worcestershire trust launches home-based pre-operative patient questionnaires

Trust has deployed fully-digital pre-op assessment process including digital health questionnaires

Worcestershire Acute Hospitals NHS Trust has launched a new digital pre-operative assessment process that includes a digital health questionnaire for elective surgery patients to complete at home.

The move comes as part of the trust’s drive to reduce the number of patients attending hospital for a full pre-operative assessment (POA), increase pre-operative capacity, and enable patients to see the right nurse at the right time.

Current wait times for surgery can be lengthy, and if a patient is told last minute they are unfit, it can be very frustrating

It will also help the trust, which completes an average of 14,000 pre-operative assessments each year, to reduce the amount of face-to-face contact between patients and staff, particularly in light of COVID-19.

Patients waiting for operations at Worcestershire Royal Hospital (WRH) can now complete their patient history questionnaire at home using a link sent from the trust to their tablet, PC or smartphone.

The results are then sent to the trust’s pre-operative assessment department where staff can triage and swimlane patients into the correct fitness and readiness categories.

Rachel Foley, senior sister for pre-operative assessment countywide at the WRH theatre admission unit at Worcestershire Acute Hospitals NHS Trust, said: “We had found ourselves spending an increasing amount of time assessing patients that were fit for surgery and so did not actually require an hour appointment for a pre-operative assessment in hospital, whereas some patients needed longer than an hour with a member of the team.

“To help identify these fit and healthy patients and drive down unnecessary POA attendances, we worked alongside Intouch with Health to launch Synopsis Home.

“Our elective surgery patients can now complete their health history questionnaire from the comfort of their own home, in their own time, then submit the answers in real-time to our clinical teams.

Frequent attendees will also be able to copy forward some parts of their pre-op assessments.

“After assessing the answers, our clinical staff can then quickly triage and separate the patients that are fit and ready for their operation and don’t require a full POA in hospital from those that do.

Synopsis Home is supporting us to reduce unnecessary POA visits so we can lower the number of patients in waiting rooms at any one time. This will be especially beneficial as we tackle the backlog of elective surgery postponed due to the coronavirus pandemic

“Staff also benefit from referrals and replies being contained within one system, alongside completed risk assessments.”

She added that the system would help the trust to maintain social distancing practises while COVID-19 is still front of mind.

She said: “Synopsis Home is supporting us to reduce unnecessary POA visits so we can lower the number of patients in waiting rooms at any one time. This will be especially beneficial as we tackle the backlog of elective surgery postponed due to the coronavirus pandemic.”

The launch of Synopsis Home at the trust is also underpinned by its recent introduction of Synopsis iQ, a fully-digital pre-operative assessment platform.

The platform has replaced the three separate systems the trust previously used to co-ordinate pre-operative assessments. It also includes decision support with an ASA, POSPOM and many other clinical scores.

Foley said: “Synopsis iQ allows those patients who come to the hospital for their POA to complete their health questionnaire digitally with the results made available immediately for triage staff. This ensures we work paper-light within pre-op and work towards a patient digital care record.”

She added: “Earlier POA interventions are allowing us to identify patients at high risk of being unfit for their operation and intervene sooner and with more-effective medical input to ensure they stand the very-best chance of their surgery going ahead.

“This also helps improve patient experience. Current wait times for surgery can be lengthy, and if a patient is told last minute they are unfit, it can be very frustrating.”

Michael Applewhaite, Synopsis regional sales director at Intouch with Health, said of the deployment: “The trust was previously using three separate systems to manage the POA pathway, which was unwieldy for staff to access and created integration issues.

“A key problem was that, while the previous software captured most of the POA, it couldn’t capture activities or additional information. This meant this information was added in a separate piece of software which was not audited and had no version history.

“Implementing Synopsis iQ and Synopsis Home has enabled the trust to bring the POA process into one area, while capturing all stages of the process.”

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