A pioneering ‘surgery school’ developed by clinicians in Southampton is transforming the fitness of patients prior to their operations – and reducing the time they spend in hospital.
The initiative was launched by Professor Mike Grocott, a consultant in critical care at University Hospital Southampton NHS Foundation Trust, and his team in 2016.
It sees groups of 10 patients who are due to undergo bowel, urological or gastrointestinal surgery attend a two-hour session once a week with the lead nurse, a dietitian and a member of the therapies team to find out more about improving their health and fitness.
Topics covered include the benefits of exercise, nutrition, alcohol education and smoking cessation – all with the aim of reducing patients’ risk of complications post-surgery and the length of time they spend in hospital.
As part of the project, patients are given advice on what types of exercise to undertake and can be referred to the specialist advisers at Southampton Healthy Living for advice on how to quit smoking, as well as a dedicated alcohol support team.
Results of a two-year audit of the programme, presented at the Evidence Based Perioperative Medicine (EBPOM) conference in Dingle, Ireland, showed almost half of patients (48%) who were inactive prior to attending the school reported increasing their physical activity levels and making lifestyle improvements.
During the reporting period, 450 of 848 patients invited took part in the school, with 63% saying they were likely to make a lifestyle change as a result of attending and 98% likely to recommend it to a friend having surgery.
Overall, 46% of patients who attended increased their activity compared with 25% who did not and, on average, spent one day less in hospital with fewer post-surgery complications.
“We are really pleased with the results we have seen so far and we hope the project continues to grow both within the trust and further afield,” said Imogen Fecher-Jones, perioperative medicine lead nurse at UHS.
“It is already well-established that patients who are in good physical shape prior to surgery have fewer complications and enjoy a quicker recovery, so the key is to engage more patients to take action – particularly in the hard to reach groups.”
Professor Denny Levett, clinical lead for the perioperative medicine service, added: “What these initial results show us is that we are making huge strides in that area, with almost half of patients who were inactive reportedly increasing their physical activity and making lifestyle improvements as a result of the school.”
The surgery school is one of a number of initiatives, known as Fit-4-Surgery, introduced by the perioperative medicine team, with novel pre-surgery exercise sessions for cancer patients – known as ‘prehabilitation’ – being trialled across the region as part of a £2.3 million study.
In addition, the team has received a £1.8 million NIHR Health Technology Assessment grant in collaboration with University Hospitals Bristol NHS Foundation Trust to evaluate the effectiveness of muscle training before major operations to reduce pneumonia after surgery.
Follow the team’s activity on Twitter @UHS_POM.
Posted on Monday 22 October 2018