PATIENT PERIOPERATIVE EXPERIENCE AT ST. BARTHOLOMEW'S DURING THE COVID-19 PANDEMIC

Abstract

IntroductionThe pressure of the global COVID-19 pandemic led to unprecedented changes in the delivery of healthcare services in a short period of time. Due to the nature of cardiothoracic surgery, there was an urgent need to adapt and continue delivery of services whilst maintaining patient and staff safety (1) St. Bartholomew's Hospital is a Cardiothoracic tertiary centre. The trust underwent mass redistribution of intensive care services and creation of a new hospital (The Nightingale) to manage the influx of COVID-19 patients. Therefore, the delivery of cardiothoracic perioperative services changed significantly, requiring online or telephone appointments for pre-op assessment clinic; strict no visitors policy and the need for patient self-isolation prior to hospital admission. Delivering perioperative care in this new environment was challenging and we wanted to investigate how these changes impacted the perioperative experiences of cardiothoracic patients during this time with the aim of improving any shortcomings identified.MethodsBetween 7-8th September 2020, all patients who were at least 48h post-procedure were given a self-administered paper questionnaire after verbal consent was obtained. This consisted of a total of eight structured and unstructured questions. These were analysed using simple frequency analysis and manual analysis respectively. Common themes were identified.Results51 patients completed the questionnaire - 39 cardiac and 12 thoracic patients. The main themes were pain and surviving the operation with concerns regarding family. 88% of patients positively recalled speaking to an anaesthetist face to face, with over half of these interaction being a day before their surgery. 92% felt meeting the anaesthetist was useful in addressing their worries and helped with anxiety. Information delivery regarding post-operative pain was an overwhelming theme and potential area for improvement. 88% of patients would recommend St. Bartholomew's hospital to friends and family. 64.8% who completed the question “Is there anything else you want to tell your anaesthetists or critical care doctors?” wanted to express their gratitude to all healthcare professionals involved in their care. Interestingly, a number of patients reported that they would like information about lifestyle changes and identified a potential window for signposting for more support.DiscussionUnfortunately, there is little national or international data for direct comparison of our findings. Post-operative pain expectations can be further explored to establish whether more preoperative information surrounding analgesia is required. Anaesthetists should be aware that the perioperative period for major surgery is a teachable moment for potential lifestyle changes and could play an important part in utilising this opportunity. We hope that this simple questionnaire can provide healthcare staff a better insight into perioperative patient experience and the importance of preoperative provision of information. Despite significant changes during the pandemic, it is reassuring to know that the overall patient experience was positive.