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Chapter 2: Guidelines for the Provision of Anaesthesia Services for the Perioperative Care of Elective and Urgent Care Patients 2024
Anaesthetists should be involved in audit and quality improvement cycles, preferably using a ‘rapid cycle’ quality improvement approach. This approach benchmarks standards of care and may be an effective change driver. It is also an excellent way of providing evidence of good practice as defined by the GMC, and mapping the contribution that individuals make to any service within their...
Chapter 2: Guidelines for the Provision of Anaesthesia Services for the Perioperative Care of Elective and Urgent Care Patients 2024
Regular revision at locally agreed timeframes and audit of standards of care, guidelines and protocols and critical incident reporting are essential in the continuing development and improvement of post-anaesthetic patient care.183
Chapter 2: Guidelines for the Provision of Anaesthesia Services for the Perioperative Care of Elective and Urgent Care Patients 2024
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.
Chapter 2: Guidelines for the Provision of Anaesthesia Services for the Perioperative Care of Elective and Urgent Care Patients 2024
All patients should be assessed prior to anaesthesia or anaesthesia-led sedation. This could be conducted face to face in a clinic or virtually (any interaction that does not take place face to face).41,42 The majority of preoperative assessment will be nurse led and delivered (in association with allied health professionals and pharmacy staff) using locally agreed and developed protocols.43
Chapter 2: Guidelines for the Provision of Anaesthesia Services for the Perioperative Care of Elective and Urgent Care Patients 2024
An anaesthetic preoperative assessment service should involve consultant anaesthetists and staff grade, specialty and associate specialist (SAS) doctors.41,42,44 Dedicated anaesthetic presence in the preoperative assessment and preparation clinic is required for:
- the review of results and concerns identified by preoperative staff
- consultations with patients identified using a triage process to allow optimal delivery of preoperative...
Chapter 2: Guidelines for the Provision of Anaesthesia Services for the Perioperative Care of Elective and Urgent Care Patients 2024
An appropriate level of staffing and suitable facilities should be available to deliver a good quality preoperative service. Non-anaesthetist health professionals, such as, specialist nurses, pharmacy staff, allied health professionals and Anaesthesia Associates (AAs) add considerable value to the service.42,46,47
Chapter 2: Guidelines for the Provision of Anaesthesia Services for the Perioperative Care of Elective and Urgent Care Patients 2024
There should be a designated lead anaesthetist for this service with specific programmed activities for this role within their job plan. The lead anaesthetist is responsible for:
- the training and support of nursing, ODPs and other staff
- the maintenance of close two-way links with primary care clinicians facilitating agreed evidence based ‘fitness for surgery’ protocols between primary and secondary care...