• Electronic Pre Operative Assessment Questionnaire (ePAQ) in South Yorkshire

·        ePAQ is an electronic pre operative assessment questionnaire that improves the efficiency of pre operative assessment. An opportunity was identified to aid elective recovery by increasing its use remotely.  A review of the EPAQ criteria was completed to ensure that these were visible and consistent. This included materials to maximise appropriate use of EPAQ.

·        A risk stratified approach was taken to identify a cohort of patients to be directed to complete ePAQ at home through a link sent out via email, this is now approximately 20% of patients.

·        A dashboard allows the Pre OP Assessment Team to track the patients progress completing ePAQ.

·        A follow up phone call focuses on areas requiring further exploration indicated by ePAQ responses and provides patient information prior of surgery.  The remote completion of ePAQ enables patients to be invited for necessary tests at a single visit. 

·        It was introduced alongside the establishment of a pre op assessment service in central Sheffield, away from the acute hospital site, supporting social distancing & delivery in covid light environment.

The impact

Patients were surveyed upon the introduction of ePAQ and the feedback was positive, particularly in relation to avoiding multiple hospital visits.  Upon introduction of increased remote use of ePAQ patient feedback continues to be positive. ePAQ contributes to reducing the waiting time for a nurse practitioner appointments by avoiding unnecessary face to face assessments and thus supporting social distancing requirements through the Pre Op Assessment Service.

Key Learnings

What specific factors supported or hindered progress?

Progress was supported by the Trust Executive Team approving the delivery of an electronic pre operative assessment questionnaire and supporting the move to enable it to be used remotely.  Progress was also supported by strong clinical leadership and support from across the whole Pre Op Assessment Team. Links with Surgeons / Outpatient teams and Waiting list co-ordinators are key to ensure that EPAQ is clinically led. Practicalities such as securing support from Outpatient Departments took time, ongoing two way communication with outpatients is critical to the successful and sustainable delivery of ePAQ. Provision of clear information for all key stakeholders is a key enabler in identification of patients – this should include patients as partners in the process.

What would you change about the initiative in hindsight?

It would be ideal if the electronic preoperative assessment questionnaire had a link into the Trusts system so that key information could be populated automatically at the point of completion. It is not currently possible, but work continues to enable key information to be populated.

What advice would you impart to other systems?

Gain support from your Executive Team and take your time to engage clinical teams in all aspects of the development from the outset.  Review your processes and consider how ePAQ could support streamlining the delivery of your Pre OP Assessment Service and develop clear standard operating procedures. Ensure capability and capacity within existing pre-operative services to ensure timely review, triage and annotation of EPAQ questionnaires to avoid process delays

Is your idea a commercial offer , or does it have the potential to be a commercial offer?

Unsure

Which part of the pathway does your idea focus on?

Pre - elective care