Setting the scene for Perioperative Medicine in Ireland: a survey of the attitudes, beliefs and current practice of anaesthesiologists.

Question Title

* 1. Please select the grade at which you currently work?

Consultant

SAT 1-2

SAT 3-6

NCHD

Other (please specify)

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* 2. When do you think anaesthesiologist’s involvement in the care of the surgical patient should start? (Please mark all that apply)

When the patient is referred to the surgical outpatient clinic

When the decision to operate is made

At the preoperative assessment clinic

On the day of admission for surgery

In the anaesthetic room

Other (please specify)

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* 3. When do you think the anaesthesiologist’s involvement in the care of the surgical patient should end? (Please mark all that apply)

In the recovery room

At a fixed point after surgery (e.g. 24 hours, day 3 etc)

Once there are no acute clinical issues

Once the acute surgical issues are resolved

Once the patient is discharged from hospital

Other (please specify)

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* 4. What do you consider to be the key components of perioperative care? (Please mark all that apply)

Preoperative assessment

Quantification of perioperative risk

Identification of co-morbidity

Identification of geriatric syndromes (e.g. frailty, cognitive impairment)

Medical optimisation (e.g. treatment of anaemia, diabetes, heart failure)

Anaesthetic planning

Assessment of capacity to consent to procedure

Taking consent for anaesthesia

Taking consent for surgical procedure

Anaesthetising the patient

Management of postoperative medical complications

Discharge planning

Longer term post discharge follow-up of postoperative complications (e.g. delirium, acute kidney injury)

Other (please specify)

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* 5. Do you apply risk prediction scores during pre-operative assessment?

Always

Never

Sometimes – if so, what prompts this?

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* 6. If you use one, or more, risk prediction scores in practice, please specify below which tool(s) you use

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* 7. At the hospital where you currently work, do you have a clinical lead for preoperative assessment?

Yes

Not sure

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* 8. At the hospital where you currently work, what staff routinely works in the preoperative assessment clinic?

Nurse

Nurse and NCHD

NCHD only

NCHD and consultant anaesthesiologist

Nurse and consultant anaesthesiologist

Dedicated session for consultant anaesthesiologist

Not sure

Other (please specify)

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* 9. Who do you think should make up the team that delivers perioperative medicine? (Please mark all that apply)

Anaesthesiologist

Intensivist

Medicine for the Elderly specialist

Organ specific physicians

Nurse / Advanced Nurse Practitioner

Other (please specify)

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* 10. Do you consider yourself a perioperative medicine doctor?

Yes

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* 11. What speciality should have clinical governance over the perioperative medicine service?

Anaesthesiology

Critical Care Medicine

Acute Medicine (e.g on-call medical team)

Medicine for the Elderly

All of the above

Other (please specify)

Question Title

* 12. Anaesthesiologists are being asked to increase their input into perioperative services. We have listed some factors that may be seen as barriers to anaesthesiologists delivering a perioperative medicine service. Please select all that you feel apply.

Anaesthesiologists do not want to practice perioperative medicine

Increased input by anaesthesiologists into the perioperative pathway will not affect patient outcomes

Anaesthesiologists lack sufficient training to deliver perioperative medicine

Physicians are better placed to deliver perioperative medicine

Surgical teams are reluctant to allow increased input by anaesthesiologists into perioperative services

There are not enough anaesthesiologists to allow this additional job role

There is a lack of evidence to show that it improves patient outcomes

A perioperative medicine service could deskill surgical teams in the management of postoperative complications

Question Title

* 13. In your last week at work, how many times did you visit a postoperative patient (other than to advise on pain management issues)?

I didn’t see any postoperative patients on the ward in the last week

Once

2-4 times

5-7 times

7 or more times

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* 14. In your last week at work, if you visited a postoperative patient, please indicate why.

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* 15. Please indicate your current location of clinical practice.

South/South West Hospital Group

RCSI Hospital Group

Ireland East Hospital Group

Dublin Midlands Hospital Group

Children’s Hospital Group

Saolta Hospital Group

University of Limerick Hospital Group

Other (please specify)

Setting the scene for Perioperative Medicine in Ireland: a survey of the attitudes, beliefs and current practice of anaesthesiologists.

Question Title

* 1. Please select the grade at which you currently work?

Question Title

* 2. When do you think anaesthesiologist’s involvement in the care of the surgical patient should start? (Please mark all that apply)

Question Title

* 3. When do you think the anaesthesiologist’s involvement in the care of the surgical patient should end? (Please mark all that apply)

Question Title

* 4. What do you consider to be the key components of perioperative care? (Please mark all that apply)

Question Title

* 5. Do you apply risk prediction scores during pre-operative assessment?

Question Title

* 6. If you use one, or more, risk prediction scores in practice, please specify below which tool(s) you use

Question Title

* 7. At the hospital where you currently work, do you have a clinical lead for preoperative assessment? ﻿

Question Title

* 8. At the hospital where you currently work, what staff routinely works in the preoperative assessment clinic?

Question Title

* 9. Who do you think should make up the team that delivers perioperative medicine? (Please mark all that apply)

Question Title

* 10. Do you consider yourself a perioperative medicine doctor?

Question Title

* 11. What speciality should have clinical governance over the perioperative medicine service?

Question Title

* 12. Anaesthesiologists are being asked to increase their input into perioperative services. We have listed some factors that may be seen as barriers to anaesthesiologists delivering a perioperative medicine service. Please select all that you feel apply. ﻿

Question Title

* 13. In your last week at work, how many times did you visit a postoperative patient (other than to advise on pain management issues)?

Question Title

* 14. In your last week at work, if you visited a postoperative patient, please indicate why.

Question Title

* 15. Please indicate your current location of clinical practice.

* 7. At the hospital where you currently work, do you have a clinical lead for preoperative assessment?

* 12. Anaesthesiologists are being asked to increase their input into perioperative services. We have listed some factors that may be seen as barriers to anaesthesiologists delivering a perioperative medicine service. Please select all that you feel apply.