Thanks to the hard work of expert staff and some innovative new methods of working, the South West London Elective Orthopaedic Centre – which was transformed into a temporary intensive care unit during the first wave of the pandemic – has been back on track with its operating lists since August.
With support from the digital patient pre-operative assessment app, LifeBox ePOA, the surgical teams at SWLEOC have been triaging patients with joint and tissue conditions remotely, not only reducing unnecessary trips to hospital but helping the centre to reduce the waiting lists caused by the pandemic.
And while SWLEOC, based in Epsom, Surrey, has become an intensive care unit once again during the latest lockdown, it is still carrying out the virtual POAs ensuring patients will be `surgery-ready’ for when operating lists can resume.
The team have also introduced a series of one-stop clinics, meaning that once a patient has been assessed by a surgeon and an operation is confirmed as needed, they are then seen by the nursing team for their ECG, swabs and relevant blood tests, all on the same day. The patient is then provided with a LifeBox login to complete their electronic health questionnaire at home within the next 48 hours.
The completed electronic health questionnaire and tests results are reviewed by SWLEOC’s pre-assessment team with a phone call to patients to verify the health information provided. At this point, if all are within range and safe for surgery, the patient is deemed ready to be put forward for an operation and a date is given. This process used to take three to four weeks, now it takes just two days.
Mary Richardson, Director of SWLEOC, recognised as one of the largest joint replacement centres in Europe, says the benefits of a one-stop clinic combined with virtual assessment of patients is “simply common sense.”
“We wanted to streamline the patient experience. To stop patients coming into hospital unnecessarily, we had to think differently,” she says. “Now, our patients – who are often in pain – don’t have to travel to us or take a day off work to be seen by our nursing teams, which also helps us to stop the spread of COVID.
“We have been back on track with our operating lists since August and we are still forging ahead. COVID swabs need to be done prior to surgery and, once we are able to resume our operating lists, the only thing that will stop that operation taking place will be if the patient has COVID.”
LifeBox ePOA was first introduced to the Epsom Hospital in summer 2019 and now all orthopaedic patients referred to SWLEOC by its NHS trust partners are assessed virtually (Epsom and St Helier; Kingston Hospital; Croydon University; St George’s). For a small percentage of patients who do not have access to a smart phone or computer, the pre-assessment nurses will complete the health questionnaire with the patient over the phone. According to NHSx, after the first six months of COVID, SWLEOC had avoided 3,060 out-patient appointments and saved patient an average 1.92 hours (before LifeBox ePOA, patient attendance time per POA was 3.2 hours).
“During the first surge of COVID, our surgeons went through the notes of every patient to clinically assess their priority. When the centre was given the go ahead to restart elective surgery on June 1, we were able to call patients already in the system and already pre-assessed,” explains Simla Ancharaz, advanced nurse practitioner. “After carrying out checks to ensure patients’ conditions had not changed, we were able to start operations just over two weeks later.”
LifeBox ePOA was created by clinicians at digital health technology company, Definition Health, and was launched in 2018. Up until the March lockdown this year, 35,000 patients already benefitted from its remote management of their pre-surgical care. Since the COVID crisis, it has witnessed rapid adoption among private and NHS hospitals as medical teams embrace digital health technology in a bid to keep patients safe.
The team behind LifeBox ePOA has recently launched Secure Virtual Clinic (SVC) – software which provides secure patient-practitioner consultation via video or audio call, whilst allowing secure two-way file uploading, information sharing and complete follow-up to ensure medical continuity.
The combination of SVC with the LifeBox ePOA app provides the UK’s first end-to-end digital surgical journey.
“LifeBox ePOA and SVC have both been designed by clinicians with the main aim of keeping patients safe and reducing risk,” says Definition Health co-founder Dr Rosie Scott, a practising NHS consultant radiologist. “With the coronavirus, we have witnessed the adoption of our preassessment app move forward by two years within a matter of weeks and now hospital teams understand we cannot simply go back to the business as usual of lengthy face-to-face appointments and bringing patients into hospital to fill in forms.”