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Prospective Surgeons - A Comprehensive Service

Dr Wells provides an unusual breadth of support for his surgeons who he engages throughout the full spectrum of patient care rather than just attendance on the day of surgery; this is primarily managed through leveraging off his fully-featured website portal and other information technologies.

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Dr Wells' primary goal is to target his technical and interpersonal expertise at achieving the best possible outcome for your patients on their day of surgery, and coordinate an efficient turnover of those patients within the theatre environment. In his experience this is not an isolated activity, but involves building up an efficient team within that private hospital, that works regularly together, and he has on occasion advanced the interests of his surgeons by advocating with hospital management the creation of the most effective team available from the available staff pool.

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Early in his career, Dr Wells observed that surgeons and patient often liaised with their anaesthetist only on the day of surgery. While this mostly delivered an adequate result, the limited engagement occasionally left a proportion of patients to be cancelled due to unexpected medical problems, and contributed to inefficiencies on the day due to the requirement to establish details through the preoperative interview; particularly with staged-arrivals of patients that prevented all assessments to be done prior to the commencement of a session.

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Additionally, for the patient, he observed that first contact with the anaesthetist immediately prior to having an anaesthetic could involve some significant anxiety, whether that be due to their unfamiliarity, or the lack of opportunity to ask pertinent questions, or due to their lack of knowledge regarding the anaesthetic choices and procedures being offered to them for their surgery. It seemed likely that this could lead to patient dissatisfaction and directly impact on the overall view of a service, which inevitably feeds into the overall referral base of a surgeon.

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Dr Wells also believes this interaction is undergoing change, with a community that has an increasing expectation of a fuller and more extended engagement with their anaesthetist; this webportal is designed to facilitate a framework for such an engagement when indicated.

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Since implementing his webportal, Dr Wells has been surprised just how many patients have reported their satisfaction with the engagement they have received relative to past surgeries, not only to himself but to his surgeons, and this is in part due to the functions of this webportal.

Flowchat of usual anaesthesia

In more specific terms, Dr Wells, and certain selected colleagues, have sought to solve this disconnect by engaging selectively with patients before, during and after surgery for any substantive procedure and as the need arises; this is done primarily through his online webportal and by applying the following strategies:

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  1. Every patient for which we have a mobile number or e-mail address having a significant procedure and who has not gone to a pre-admission clinic is contacted via SMS or e-mail and directed to our online preoperative health survey which takes only minutes to complete.

  2. Any red flags are identified and then the patient is asked to either fill out the more extensive survey, or emailed for further information, or contacted directly by phone to discuss the matter.

  3. This contact prior to the operation is used as an opportunity to direct patients to our online brochures and blogs which may be relevant to their particular surgery; these are often tailored to the needs of our surgeons. This results in a more informed, less anxious, and more satisfied patient population.​

  4. Financial consent is generally managed prior to the operation, and in our view is much easier given that contact has already occurred in other ways with the anaesthetist.

  5. 5. On the day of the operation we apply our technical skills and knowledge in a targeted manner to achieve the best outcome possible; our patients already know us, have had the opportunity to contact us, and have been educated about the relevant anaesthetic issues on the day.

  6. After the surgery a proportion of patients, and most of the larger cases, are flagged for a post operative survey to ensure they are doing well. It is important to remember that not all complications happen on the day of surgery, and early detection of an evolving problem after surgery is often a significant factor in facilitating good outcomes.

  7. After surgery, if the patient has an issue, they also have access to a direct number and e-mail for their anaesthetists: their voceimails are flagged as an audio or email on the anaesthetists mobile phone; this obviously is not an emergency service but reduces the barriers that facilitate contact.

 

While this is an extensive interaction, in actual practice it requires very little overhead and minimal time on the part of the patient and ourselves to provide this service as we leverage off our webportal and other integrated technologies behind that website portal that are commercial in confidence.

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Finally, Dr Wells has created an association called Elite Anaesthesia which pools Anaesthetists from around Sydney as "Associates". It is not a financial grouping, but rather a list of anaesthetists with common interests and goals. Communication is via a Whatsapp group which Dr Wells is administrator and this allows ready coverage for lists when Dr Wells himself is not available.  Dr Wells provides this as a free service, and absorbs the costs of the infrastructure on a pro bono basis given that it assist both his surgeons and his fellow anaesthetists.  In time he expect this will provide tremendous reach given its open-ended structure.  Without delving into technical details, Whatsapp has technical advantages over SMS systems such as end-to-end encryption and which is important for patient confidentiality, and also has the ability for all recipients to see when a surgical session is filled.

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Finally, Dr Wells is happy to provide a dedicated webpage for his own surgeons and dentists in case they have specific information they wish to direct to patients or simply wish to itemize their own services to GPs or the general public without the costs and inconvenience of a full website portal. He can password protect this page if you prefer so that information (e.g. on say bowel preparations) is accessed only by your patients and not the general community. Dr Wells' webportal is maintained in-house which makes streamlining it to your needs relatively straightforward.

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All of this is essentially a re-imagining of the patient care experience, with the anaesthetist in particular, and leverages off available technologies that are now common in the community but not commonly used by providers. Our goal is to streamline and improve the entire process in the best interests of our patients, and for the benefit of our surgeons.

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