Models of prehabilitation in Cardiff in Wales | EBPOM 2020 London
“The people of Wales are particularly unfit”, there is a high incidence of smoking, physical inactivity, and alcohol intake. Grim news from one angle but on the other hand it’s a huge opportunity to make a massive difference in the prehabilitation stage of the perioperative process. Hear how cancer outcomes are being dramatically improved as a clear pathway of optimisation is rolled out. Presented by Rachael Barlow, National Lead, Enhanced Recovery, Prehabilitation and Optimisation, at Cardiff and Vale health board, Wales.
EBPOM London 2020 | Prehabilitation Update
2020 was a big year for prehabilitation, the advent of a global pandemic has only increased the importance of this exciting field of medicine. Various questions from EBPOM 2020 attendees were tackled by the panel: Can you use “Timed Up and Go” (TUG) and The Duke Activity Status Index (DASI) to screen out unnecessary cardio-pulminary exercise testing (CPET)? What exactly is prehabilitation and what’s its natural scope? How important is nutrition? Is it possible to standardise these areas more? What areas are being significantly worked on in prehabilitation medicine in the UK this year? What about – in these COVID 19 times – remote screening and assessment? Also, what about the possibilities regarding aerosolisation, particularly of COVID-19, during CPET? Can prehabilitation work to minimise time spent in hospital? Presented by Mike Grocott, Professor of Anaesthesia and Critical Care Medicine at the University of Southampton with Karen Kerr, Consultant Anaesthetist, Departmental Lead for CPET, Sheffield Teaching Hospitals (STH) and featuring panelists; Denny Levett, Professor in Perioperative Medicine and Critical Care at the University of Southampton and a Consultant in Perioperative Medicine at Southampton University Hospital NHS Foundation trust (UHS), 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 and Steve Wootton, OBE, Associate Professor in Nutrition at the University of Southampton with an honorary appointment with University Hospital Southampton in Clinical Nutrition.
EBPOM 2020 London | Models of Prehabilitation, South Tees and PREP-WELL
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.
EBPOM Highlight | Delivering Personalised Care: aligning prehabilitation with healthcare policy
How can we align personalised care with prehabilitation? “Personalised care is where people have more choice and control over how their health and care needs are met” where we recognise “people themselves can sometimes be the best integrators of health and care”. In this context our role is to support them to “live as independently as they wish”. With shared decision making and personal choice at the heart of this we allow patients to be “experts in their own lives, health and care”. The increase in life expectancy means more long term conditions and comorbidities in patients, what opportunities does this present? How do we hone in on what matters to patients and help them manage the cumulative burden of long term health difficulties? How comfortable are healthcare practitioners when talking about physical activity? Is it possible that personalised care could eventually be business as usual? The NHS Long Term Plan has a website which you can see here: https://www.longtermplan.nhs.uk/ The NHS website is here: www.england.nhs.uk Presented by Anna Lowe, Programme manager, National Centre for Sport and Exercise Medicine, Lead Allied Health Physical Activity Clinical Champion at Public Health, England.
EBPOM 2020 London | Prehabilitation Business Case? A slam dunk!
“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.
EBPOM 2020 London | “The international prehabilitation society”
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.
EBPOM 2020 London | Models of Prehabilitation, Southampton and Wesfit
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.
EBPOM 2020 London | Models of prehabilitation in Cardiff in Wales
“The people of Wales are particularly unfit”, there is a high incidence of smoking, physical inactivity, and alcohol intake. Grim news from one angle but on the other hand it’s a huge opportunity to make a massive difference in the prehabilitation stage of the perioperative process. Hear how cancer outcomes are being dramatically improved as a clear pathway of optimisation is rolled out. Presented by Rachael Barlow, National Lead, Enhanced Recovery, Prehabilitation and Optimisation, at Cardiff and Vale health board, Wales.
EBPOM London 2020 | Guidance on prehabilitation for cancer
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.
EBPOM 2020 London | Models of Prehabilitation in Greater Manchester
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.