Perioperative digital playbook

This resource provides support to clinical teams and organisations that are looking for digital tools that support the delivery of patient pathways. We concentrate on perioperative pathways and how to share diagnostics and deliver monitoring and support to patients. We welcome feedback on the playbooks, including ideas for further case studies. To get in touch, please email digital.playbooks@nhs.net

Scenarios

I want to provide digital consent to treatment

Digital solutions to streamline the consent process.

I want to provide perioperative patient education

Remotely support patients to prepare for surgery using digital platforms.

I want to support the physical and mental health needs of patients

Digital solutions to improve patient self-management before and after surgery.

I want to provide digital preoperative assessment (POA) for patients

Clinicians and patients could complete preoperative health assessment questionnaires remotely. By recording information in one place it would support the clinical decision making process and improve patient experience.

Pathway

Perioperative pathway

Explore case studies at different steps along the perioperative pathway

Case studies

Photo of mobile phone and laptop screen showing an app to improving shared decision making and digital informed consent

Improving shared decision making and digital informed consent at Nottingham University Hospital NHS Trust

Using a digital content and consent platform to give patients information about their procedure, time to consider and guidance to complete an informed consent process at home.

Close up of a consent to treatment form with a pen

Digital consent to treatment in North West London

Read about how digital consent has been successfully introduced across 2 organisations in North West London, and what was learnt during the first 12 months.

A doctor leading a virtual group education session on a laptop

Implementing a virtual patient group education programme

Using virtual group sessions to help patients get ready for surgery.

Remote surgical prehabilitation

Digital solutions to help prepare the body and mind before surgery.

A whiteboard showing a tick box with yes or no options.

Worcestershire Acute Hospitals NHS Trust consent for surgery

Digitising consent for patients undergoing planned procedures and to support shared decision making.

Close up of woman holding iPhone in one hand with an outstretched finger about to tap the screen

Using a digital prehabilitation tool to support patients preparing for surgery

Developing an app targeting the health and wellbeing of patients undergoing elective surgery and helping clinicians identify patients who might need specialist services.

Top of table with a tablet being used for home-based prehabilitation telehealth

Kent and Medway prehabilitation telehealth delivered home-based patient optimisation

A digital prehabilitation solution to deliver a personalised service for patients.

Photo of a person holding a tablet filling out a pre-operative assessment form.

Developing a digital preoperative assessment pathway and clinical decision support

Creating a digital platform accessible from home for preoperative assessments.

Three surgeons wearing green surgical gowns working on a patient in an operating theatre

Digitally supported elective pathways at West Hertfordshire Hospitals NHS Trust (WHHT)

Creating a digital platform to capture and communicate all information required to prioritise patients for surgery.

Mac Book laptop with iPhone partially sitting on the keyboard and trackpad

Digital preoperative assessment (POA) at Guy’s and St Thomas’ NHS Foundation Trust (GSTT)

Implementing a digital POA system that patients and clinicians can use on any device connected to the internet.

Person sat at desk with a laptop and clipboard, holding paper in hands

Making digital preoperative assessment (POA) the default at South West London Elective Orthopaedic Centre (SWLEOC)

Designing a digital POA system to increase efficiency for patients and staff.

Photo of patient with a wearable sensor worn on the upper arm

Preoperative virtual ward reducing bed occupancy through monitoring of hot gallbladder

The virtual ward team at Norfolk and Norwich University Hospitals NHS Foundation Trust introduced a care pathway for patients with hot gallbladder (cholecystitis) to allow for monitoring and management of symptoms at home until their cholecystectomy.

Patient-completed, web-based preoperative assessment (POA) electronic questionnaire at Sheffield Teaching Hospitals

Digitally supported preoperative assessment increasing preoperative assessment clinic capacity to support elective recovery activity.

Development of an app based integrated prehabilitation, perioperative pathway management and patient assessment platform

App based preoperative enhancement solutions integrating medical and physical optimisation, real time physiological assessment and pathway management in one place.

Close up of woman using a laptop about to tap the screen

University Hospitals Bristol and Weston (UHBW) prehabilitation service

A novel physiotherapist led prehabiliation service with integrated digital clinical note and dashboard

Hywel Dda University Health Board virtual orthopaedic prehabilitation

A tiered virtual approach to physical and psychological optimisation for patients awaiting hip and knee arthroplasties.

Use of scanning technology in theatres to improve efficiency

Royal Devon University Healthcare (RDUH) NHS Foundation Trust wished to use technology to improve speed, ease and accuracy when recording supplies and implants used in theatre areas.

Enhancing recovery and addressing the theatre backlog with the help of virtual wards

Hertfordshire Community NHS Trust and East and North Hertfordshire NHS Trust trial tech-enabled virtual wards to improve patient care and tackle elective surgery backlog.

A clinician wearing green surgical gown working in an operating theatre

Enhancing trauma theatre list planning using an end-to-end digital system

Using a digital platform to improve theatre utilisation by enhancing theatre list coordination and planning, referral management and handovers

Digital preoperative assessment triage

Digital platform for the identification and preoperative assessment of high-volume low-complexity orthopaedic cases at the Oxford University Hospitals NHS Foundation Trust (OUH).

Optimising patient flow and filling surgical slots through an electronic preoperative assessment process

Digital transformation of preoperative assessment at NHS Lanarkshire with automated care coordination and waiting list management.

Four surgeons wearing surgical gowns working on a patient in an operating theatre

Post operative monitoring and communication using a mobile app to improve patient experience and safety at Kettering General Hospital NHS Foundation Trust

A digital two-way communication app empowering patients in the post-operative recovery at home, improved wound care and decreased demand on local emergency services.

Person sat at desk with a laptop and clipboard

A virtual pre-operative patient education class

Educating patients awaiting major surgery on the importance of active preparation and modification of lifestyle.

Digital preoperative assessment triage at Chelsea and Westminster Hospital NHS Foundation Trust

Developing digital solution within an existing trust system, to better coordinate preoperative elective patient care.

A patient is submitting a response on a phone

Implementing remote monitoring of surgical wounds using smartphones

Proactive surveillance of surgical wounds using telehealth to allow real-time monitoring for the identification and treatment of wound complications.

Disclaimer

These case studies summarise user and patient experiences, focussing on:

digital solutions along different care pathways
productivity improving digital solutions
how to open source code for health and care organisations

Unless expressly stated otherwise, the apps and digital tools referenced are not supplied, distributed or endorsed by NHS England or the Department of Health and Social Care and such parties are not liable for any injury, loss or damage arising from their use.

All playbook case studies have either passed, or are currently undergoing the Digital Technology Assessment Criteria (DTAC) assessment.

Please note the full legal disclaimer: NHS Transformation Directorate playbook disclaimer