Abstract
BackgroundIn 2014, the Royal College of Anaesthetists (RCoA) launched the Perioperative Medicine Programme to facilitate the delivery of best preoperative, intraoperative and postoperative care through implementation of evidence-based medicine to reduce variation and improve postoperative outcomes. However, variation exists in the establishment of perioperative medicine services in the UK. This survey explored attitudes and behaviours of anaesthetists towards perioperative medicine, described current anaesthetic-led perioperative medicine services across the UK and explored barriers to anaesthetic involvement in perioperative medicine.MethodsSurvey content based on the RCoA vision document was refined and validated using an expert panel. An anonymous electronic survey was then sent by email to the members of the RCoA.ResultsSeven hundred fifty-eight UK anaesthetists (4.5% of the RCoA mailing list) responded to the survey. Of these, 64% considered themselves a perioperative doctor, with 65% having changed local services in response to the RCoA vision. Barriers to developing perioperative medicine included insufficient time (75%) and inadequate training (51%). Three quarters of respondents advocate anaesthetists leading the development of perioperative medicine.ConclusionsDespite evidence of emerging services, this survey describes barriers to ongoing development of perioperative medicine. Facilitators may include increased clinical exposure, targeted education and training and collaborative working with other specialties.
Highlights
In 2014, the Royal College of Anaesthetists (RCoA) launched the Perioperative Medicine Programme to facilitate the delivery of best preoperative, intraoperative and postoperative care through implementation of evidence-based medicine to reduce variation and improve postoperative outcomes
Forty-three percent had watched the RCoA video on the vision for perioperative care, and 25% had instigated changes within their hospital based on RCoA recommendations
Three quarters of anaesthetists state that they are uniquely placed to lead the future development of perioperative medicine
Summary
In 2014, the Royal College of Anaesthetists (RCoA) launched the Perioperative Medicine Programme to facilitate the delivery of best preoperative, intraoperative and postoperative care through implementation of evidence-based medicine to reduce variation and improve postoperative outcomes. To raise standards and reduce variation, national quality improvement projects and research such as the Perioperative Quality Improvement Programme (PQIP) (Perioperative Quality Improvement Program, 2019) have been established with real-time results informing iterative changes in clinical services Despite these changes, a recent survey of perioperative leads (Perioperative Quality Improvement Program, 2019) demonstrated wide variation in the delivery of perioperative medicine services by anaesthetists in routine clinical practice. Understanding the barriers to implementing perioperative medicine from the perspective of anaesthetists as opposed to perioperative medicine leads may facilitate the further development of this specialty This national UK survey, performed jointly by the RCoA and the British Geriatrics Society’s Perioperative Medicine for Older People (POPS) Specialist Interest Group aims to: Explore the attitudes and behaviours of anaesthetists towards perioperative medicine Describe current anaesthetist-led perioperative medicine services across the UK Explore barriers to anaesthetists’ involvement in perioperative medicine
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