Preparing patients for surgery: Perioperative care and general practice

Abstract

Perioperative care challenges the integration of community and hospital multidisciplinary teams to prepare patients for surgery from the moment a patient considers undergoing an operation to the later recovery from surgery. Primary care has a role in the perioperative pathway, for example, in the management of long-term conditions and in identifying treatable pathology ahead of surgery. There are many factors beyond the control of primary care that compromise the optimisation of patients’ long-term conditions or even their general health ahead of planned surgery. However, there may be opportunities to optimise patients’ relevant comorbidities when surgery is first contemplated during the increasingly protracted period before surgery. Preoperative assessment clinics (POACs) are integral to perioperative care and present an opportunity to address specific issues relating to the day of surgery and to answer patients’ questions. Often POACs see patients with long-term conditions not optimised for surgery. This is a late, and less than ideal, opportunity to prepare patients for surgery. This article seeks to identify earlier opportunities to effectively improve the preparation of patients for surgery and to avoid postponement of surgery.