Patient perspectives of ‘one stop shop’ preassessment

Abstract

Introduction We decided to explore the patient perspective of our new ‘one stop shop’ cardiothoracic surgery pre-assessment service, in which the patient sees the surgeon, specialist nurse and anaesthetist in one hospital visit. The service aims to improve patient experience by reducing the number of preoperative hospital visits, and facilitate the move of all elective patients to day of surgery admission. Identification of anaesthetic concerns in advance of admission and discussion ofEnhanced Recovery following surgery were anticipated clinical advantages. As part of the service, we give a written leaflet (1) and introduced online information videos for patients to access at home following their ‘one stop shop’ preassessment. Methods In April 2019, a year following service implementation, we surveyed 30 post-operative inpatients by use of a bedside questionnaire. All patients had attended our pre-assessment clinic before their surgery. Results We visited 16 Cardiac and 14 Thoracic patients. 100% of patients felt they received enough information to feel adequately prepared for surgery. 88% (14/16) cardiac patients received the leaflet 'Anaesthesia for Heart Surgery'(1), with 86% (12/14) finding it useful. 30% (9/30) accessed our online videos. Feedback was positive. 24% (5/21) of non-viewers, were unaware of them, but of these, only one accessed other online information. The average time spent in hospital for the ‘one stop shop’ was 5 hours 22 minutes (median 5 hours IQR 2.25 hours). 97% (29/30) felt this was acceptable and did not wish to have separate visits to the hospital. Patients found it helpful to have their partner with them, and found it ‘overall a good experience’. Staff were rated as friendly, supportive and reassuring. Suggested areas to improve upon included: appointment duration with surgeon, diagrammatic explanation of their surgery and the timing of anaesthetic appointments. Discussion Patients appear to rate our 'one stop shop' highly, and favour the reduction in number of hospital visits despite the long day. We need to highlight the availability of our online videos, signposting patients towards them during their visit to the “one stop shop” more clearly. Production of a written patient information leaflet on anaesthesia for thoracic surgery is needed.