Cognitive Prehabilitation | EBPOM Chicago
This piece goes over some cognitive risk factors for post op delirium alongside a look at cognitive prehabilitation and a review of the results from an aerobics trial. What are the next steps for future research? This piece was followed by a panel discussion which will be released soon here on TopMedTalk. For more information about Evidence Based Perioperative Medicine (EBPOM) go here www.ebpom.org Presented by Michelle Humeidan, Associate Professor, Neuroanesthesiology, Associate Faculty, Institute for Behavioural Medicine Research, Medical Director, Enhanced Surgical Recovery.
Models of Prehabilitation | EBPOM 2020
This piece is an informative conversation about the models of prehabilitation from a number of different angles. Questions come in from an online audience as our panelists tackle the topic from their respective areas. What are the risks and how are they mitigated? Where does your funding come from and why? How safe is iron for cancer patients? The link to Safe Fit self referal is here: https://www.macmillan.org.uk/cancer-information-and-support/get-help/physical-help/safefit%20#refer_yourself_to_this_service Presented by Denny Levett, Professor in Perioperative Medicine and Critical Care at Southampton University Hospital NHS Foundation trust and Honorary Associate Professor at the University of Southampton and Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Foundation Trust with their guests John Moore, Clinical Director for Intensive Care at Manchester Royal Infirmary and Medical Lead for Enhanced Recovery After Surgery, Professor Sandy Jack, PhD, Consultant Clinician Scientist in The Anaesthesia and Critical Care Research Unit at University Hospital Southampton NHS Foundation Trust, Honorary Senior Lecturer at the University of Liverpool, University of Southampton and University College London and Rachel Barlow, National Lead, Enhanced Recovery, Prehabilitation and Optimisation, at Cardiff and Vale health board, Wales.
The Business Case for Prehabilitation | EBPOM London
“It was successful early on within the National Health Service.. [because] you could eliminate the cost of some unhelpful, unnecessary tests… referrals to other “-ologists”… in our system that works, because more work is just more work. It’s not more money.” Is the business case for prehabilitation a “slam dunk”, as some enthusiasts claim? If so how do you measure value versus volume, is value always a subjective term and can the balance between the two be addressed? How does the NHS’s “internal market” compare to the US’s fee for service environment? Furthermore, where are the sensible limits of prehabilitation, how far do we take it before we move forward to an operation? This piece has been available to EBPOM London attendees since it was first recorded in the earlier part of the year. For exclusive access to other similar pieces now and in the future please visit www.ebpom.org Presented by Monty Mythen and Kay Mitchell, Senior Research Manager for critical care research, NIHR Biomedical Research Centre, University Hospital Southampton, UK, with their guests, David Selwyn, Deputy Medical Director at Nottingham University Hospitals NHS Trust and Director of The Centre for Perioperative Care (CPOC), Sol Aronson, tenured Professor, Duke University and Jeff Vender, Emeritus, Harris Family Foundation Chairman of the Department of Anesthesiology at NorthShore University Health System, Evanston, Illinois and Clinical Professor at the University Of Chicago Pritzker School Of Medicine in Chicago, Illinois
The Future of Prehabilitation “Standardisation of definitions and outcomes” | EBPOM 2020 London
“The main challenge around the variability in the perioperative period is nomenclature, definitions and standardized endpoints. Well designed and well conducted randomized control trials determine effectiveness to an unbiased comparison of outcomes, events, or endpoints between intervention groups”. If data is destiny it is to this that we must look if we want to understand what the future may hold for prehabilitation. This piece takes a pragmatic approach toward the task of ensuring information and datasets are widely applicable, as free from bias as possible and ultimately standardised by consistent definitions and terminology alongside a methodology which produces clear outcomes. Find out more about the Comet Initiative here: https://www.comet-initiative.org/ Find more about the ‘Standardised Endpoints in Perioperative Medicine-Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC) Group’ here: https://www.comet-initiative.org/Studies/Details/1317 Presented by Malcolm West NIHR funded Clinical Lecturer in Surgery and Honorary colorectal surgical specialist registrar at the University of Southampton.
Models of Prehabilitation in Greater Manchester | EBPOM 2020 London
It’s widely understood that high value care during, before and immediately after surgery is optimal whereas poor quality care in the perioperative period produces long term difficulties which are compounded by the acute stresses produced during and immediately after a procedure. This talk covers three main areas; surgical care for patients in Greater Manchester, “ERAS+”; prehabilitation for cancer, for the population of Greater Manchester; how Manchester has supported patients during the time of COVID19. This piece is mentioned in the introduction and serves as a useful compliment to the talk, “Implementing a system-wide cancer prehabilitation programme: The journey of Greater Manchester’s ‘Prehab4cancer’”: https://www.ejso.com/article/S0748-7983(20)30438-8/fulltext Find out more about the work in Greater Manchester here: https://gmcancer.org.uk/our-areas-of-work/prehab4cancer-2/ Also the Perioperative Quality Improvement Programme is here: https://pqip.org.uk/content/home Presented by Dr. John Moore, Clinical Director for Intensive Care at Manchester Royal Infirmary and Medical Lead for Enhanced Recovery After Surgery.
Guidance on prehabilitation for cancer | EBPOM London 2020
This piece looks at the most recent guidance regarding prehabilitation for cancer, developed and published in 2009 by Macmillan Cancer Care. Extremely well received across the UK, and internationally, here we look at the details and some context in terms of UK national policy. From an NHS England point of view the desire is to ensure that all patients and participants have personalized care embedded into everyday NHS services. Work around streamlining multidisciplinary team meetings for cancer include the opportunity to discuss the needs of people with cancer and the importance of preparing people in advance and during treatment. Furthermore you will hear elements of the principles of rehabilitation, as well as the importance of earlier and faster diagnosis, the importance of perioperative medicine and prehabilitation before surgery. Further reading here “Principles and guidance for prehabilitation”: https://www.macmillan.org.uk/about-us/health-professionals/resources/practical-tools-for-professionals/prehabilitation.html Originally part of the hugely successful EBPOM Live from London 2020 conference this piece is nicely complimented by the panel discussion which TopMedTalk has also released free of charge here: https://www.topmedtalk.com/ebpom-london-2020-prehabilitation-update/ Presented by June Davis, Director of Allied Health Solutions, Allied Health Professions Advisor (part time) for Macmillan Cancer Support and a professional advisor to the Care Quality Commission.
Models of Prehabilitation, South Tees and PREP-WELL | EBPOM 2020 London
This piece covers the PREP-WELL project which is a community based prehabilitation program in South Tees, in the North of England: “We established the following guiding principles; we wanted to provide patient centered care under one roof with facilitated self management; we wanted to work as a cross sector collaborative, by that I mean primary care, secondary care and public health; all working together to try and improve on the fragmented service provision and sign work that we often see in our health care services; we wanted to provide a community based facility for patients; and I’ll come to the reasons for this”. See the PREP-WELL team here: https://www.southtees.nhs.uk/services/prepwell-project/meet-the-prepwell-team/ The links mentioned in the talk are here: Home exercises: https://www.southtees.nhs.uk/services/prepwell-project/home-exercises/ Nutrition: https://www.southtees.nhs.uk/services/prepwell-project/nutrition/ Pdf download: https://bmjopenquality.bmj.com/content/bmjqir/9/1/e000898.full.pdf We’ve been following the groundbreaking success of the PREP-WELL project for some time now here on TopMedTalk, why not check out this piece here, the first part in our most recent “P.O.E.T – Perioperative Enhancement Teams” series; https://www.topmedtalk.com/poet-2-01-the-uks-prepwell-initiative/ This piece was originally part of EBPOM 2020 – Live from London, our groundbreaking virtual conference; find out more about Evidence Based Perioperative Medicine (EBPOM) here: www.ebpom.org Presented by Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Foundation Trust.
Models of Prehabilitation, Southampton and Wesfit | EBPOM 2020 London
This piece gives you the evidence base required to deliver an even higher standard of perioperative medicine where you work. Hear about the “Fit 4 surgery” studies; the “fit 4 surgery consortium”, the ongoing e-studies, key findings, recent studies and the set up in Southampton. Physical fitness is greatly affected by chemotherapy; poor outcomes are significantly linked to physical fitness; learn how preoperative cardio-pulmonary exercise testing and training can monitor and track this potentially dangerous spiral. Hear how multiple studies are now providing a clear evidence base for this exciting area of perioperative care. Could more such targeted interventions, alongside shared decision making, provide a real difference to outcomes for your patients and a higher standard of value based care in your institution? For more on this go here: http://wesfit.org.uk/ Read more about the great work being done by MacMillan Cancer Trust here: https://www.macmillan.org.uk/ The video version of this presentation, along with slides, was presented to the many thousands of people who attended the hugely successful Evidence Based Perioperative Medicine (EBPOM) virtual conference, “Live from London”. For more details on this and future conferences please visit www.ebpom.org Presented by Professor Sandy Jack, PhD, Consultant Clinician Scientist in The Anaesthesia and Critical Care Research Unit at University Hospital Southampton NHS Foundation Trust, Honorary Senior Lecturer at the University of Liverpool, University of Southampton and University College London.
Prehabilitation Business Case? A slam dunk! | EBPOM 2020 London
“In the elective surgical domain 20% of people who are scheduled to have surgery are not ready for surgery” The road towards economic reality is paved with data; this talk, confidently assertive in tone, provides you with a number of useful facts and reassurances which can be transformed into reasons why you and your patients can enjoy the benefits of prehabilitation; a better value of care and a higher standard of good quality outcomes. This piece works well in tandem with this debate here: https://www.topmedtalk.com/ebpom-london-2020-the-business-case-for-prehabilitation/ Presented by Sol Aronson, tenured Professor, Duke University, Durham, North Carolina.
“The international prehabilitation society” | EBPOM 2020 London
What are the aims of The International Prehabilitation Society? Its vision is about “bringing together international multidisciplinary expertise, across healthcare and beyond, creating a platform of shared learning, research and education for the benefit of patients”. This piece updates you on the current board members, the roles of committee members, conferences that the society has previously supported alongside those being planned for the future. Also there’s an update on some exciting new sponsorship news and a brief overview of future plans. The society’s website is here: https://prehabsociety.com/ Presented by Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Trust.