Use of patient reported outcome measures (PROMs) to assess physiological and other recovery domains after surgery could be considered.49
Older patients should be assessed for the risk of developing postoperative delirium. Preoperative interventions should be undertaken to reduce the incidence, severity and duration of postoperative delirium. Hospitals should ensure guidelines are available for the prevention and management of postoperative delirium that are circulated preoperatively to the relevant admitting teams.31
Specific, measurable, attainable, relevant and time-bound (SMART) quality improvement initiatives and safety measures could be embraced in order improve safety and develop perioperative anaesthesia services.50
Nurturing a safety culture, learning from mistakes, preventing harm and working as part of a team are all part of the discipline of safety. To this end, shared learning and quality improvement that contribute towards improvements in safety, such as critical incident reporting with thematic analysis, and communication through morbidity and mortality meetings, could be undertaken.
Anaesthetists should participate in departmental audit throughout a full audit cycle. This participation should adhere to the standards and principles outlined in the College’s Compendium of audit recipes.50
Postoperative care audits and quality improvement projects from the College’s Compendium of audit recipes could be considered.50
The written and verbal information given to patients before their admission to hospital should explain the purpose and nature of their recovery and the recovery department. You and your anaesthetic, published by the Royal College of Anaesthetists and the Association of Anaesthetists is an example of this.51 Further details on information to be given preoperatively can be found in...
Some patients, both adults and children, may need interpreters, parents or other members of their family to be with them. This need is best determined at preassessment, so that sensitivities can be taken into account in the operative process.52
Patient information regarding postoperative and post-discharge care, including contact details and protocols if complications arise, should be provided.
The following time allocation (per week) is a guide to the minimum physician anaesthetist staffing that should be provided per 1,000 inpatients passing through a preoperative preparation clinic:
