Implementing a virtual patient group education programme

80% of major elective surgery patients are at risk of complications.

Evidence suggests enhancing patients’ functional capacity, nutritional status and psychological health before surgery may reduce postoperative complications and improve outcomes.

University Hospital Southampton (UHS) started a face-to-face ‘surgery school’ to educate patients and support them to make preoperative changes to their health.

Patients accepted it and it showed that attending surgery school changes lifestyle behaviour.

Situation

The COVID-19 pandemic has made it unsafe for groups of patients to be together face-to-face.

Aspiration

UHS wants all patients to attend prehabilitation group education sessions before they have major surgery.

Solution and impact

Due to COVID-19, the team moved quickly to deliver surgery school using video conferencing.

A nurse, physiologist and dietician deliver a 1 hour 30 minute virtual group session. These sessions cover topics like:

• setting patient expectations for treatment and recovery
• improving nutrition and fitness
• how to reduce alcohol and tobacco intake

Attendance to surgery school increased, with no negative impact on patient satisfaction.

Patients found the virtual group sessions convenient, informative and confidence-boosting.

Functionality

Patients are invited to attend a live interactive video conference using Microsoft Teams.

Capabilities

• The service enables patients to receive education and benefit from the group session.
• Patients who are unable to attend due to lack of digital resources receive a one-to-one phone call instead. 
• Patients’ families can also join the session.

Scope

National guidance for Preoperative Assessment and Optimisation for Adult Surgery recommends that patients undergoing major surgery should attend virtual surgery school. This guidance is endorsed by the Royal College of Surgeons of England.

Key learning points

• Digital champions were needed to help patients get online for the surgery school. Provide a phone number for the surgery school team for patients to call.
• Making the sessions interactive helps patients stay interested.
• The team identified a need for supportive written information. Create documents for patients to use for reference.
• Give patients links and contacts if they need more information after the group session.

Key figures

• Over 12 months, 243 out of 360 patients attended virtual surgery school. This is 11% higher than face-to-face school.
• 95% of the patients surveyed said that the session was good or very good. 
• 79% of the patients surveyed said they'd change their behaviour. This was 19% higher than the group before COVID-19.
• 58% of patients said they intend to increase the amount of physical activity they do.
• 20% of patients said they would improve their diet.
• 12% of patients said they would reduce their alcohol consumption.
• 5% of patients said they intend to stop smoking.

Key contact

Imogen Fecher-Jones, Lead Nurse Perioperative Medicine, UHS

imogen.fecher@uhs.nhs.uk