Delivering perioperative care in integrated care systems

Abstract

In 2016, NHS England set up 10 integrated care systems (ICSs) which aim to devolve some responsibility for delivery of health and social care services to local healthcare providers in partnership with local government, social care, primary care networks, and voluntary and charitable organisations. These are new ways of working and provide an opportunity to better integrate perioperative care across the entire pathway from the moment of contemplation of surgery through to recovery at home. This review describes the ways in which the aims of many ICS plans can be met with good perioperative care, and how clinicians can use this opportunity to make significant progress in improving outcomes for patients. We describe examples of initiatives in cancer pathways which are already proving successful and have caught the imagination of the local community at all levels, as well as examples of integrated perioperative care across the country which can be applied to other systems. We hope to demonstrate ways in which perioperative care can add value to a local health population given the right support and chance to deliver it.

Effect of comprehensive nursing intervention on wound pain and wound complications in patients with tonsillectomy: A meta‐analysis

“…Comprehensive nursing programmes are based on the actual condition of the patient to ensure that the implementation of care is realistic to meet the needs of patients. Studies have shown that comprehensive nursing can maximise the quality of care during the entire treatment period, so that patients can receive continuous and comprehensive care services, which truly meets the individual needs of each patient and provides effective protection for postoperative recovery 33,34 …”

“…Studies have shown that comprehensive nursing can maximise the quality of care during the entire treatment period, so that patients can receive continuous and comprehensive care services, which truly meets the individual needs of each patient and provides effective protection for postoperative recovery. 33 , 34 …”

“…Studies have shown that comprehensive nursing can maximise the quality of care during the entire treatment period, so that patients can receive continuous and comprehensive care services, which truly meets the individual needs of each patient and provides effective protection for postoperative recovery. 33,34 Eighteen studies were included in this meta-analysis, focusing on the effects of comprehensive nursing interventions on postoperative wound pain in patients undergoing tonsillectomy. Our results showed that comprehensive nursing interventions applied to tonsillectomy could significantly reduce patients' postoperative wound pain, shorten hospital stay, reduce postoperative bleeding and reduce the incidence of postoperative complications.…”

Progress requires change from the norm

“…The material is wide ranging: there are articles that will be of great help the medical registrar (perioperative diabetic care, opioid management, management of surgery in frail individuals) as well as manuscripts to help with system design (in the context of integrated care systems, 'prehabilitation' initiatives, shared decision making). [1][2][3][4][5][6] The content has been invited and carefully curated by Dorian Martinez, James Goodwin, David Selwyn and many others from the RCoA who, along with the authors, deserve all the credit for this issue.…”