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Advantages and disadvantages of the traditional model

Now you’ve had an opportunity to discuss these issues from your own perspective, we will highlight some of what we believe to be the advantages and disadvantages of both preoperative and postoperative models of care.

Advantages

Preoperative

  • well suited to a large volume workload
  • works well for uncomplicated low risk patients
  • workforce costs prefer a nurse-delivered preoperative assessment
  • rapid throughput of patients

Postoperative

  • uses the knowledge, skills and experience of surgical teams
  • clear clinical accountability
  • a consistent team
  • prompt involvement of surgeons for surgical complications

Disadvantages

Preoperative

  • it is less suited to a multimorbid population or patients who have unrecognised disease and functional issues
  • little opportunity to optimise patients and modify risk
  • generation of referral to primary care or multiple organ specific services
  • delays in the timeline to surgery
  • possible labelling of patients as “medically unfit”, which may influence future decision making
  • no single point of contact for case coordination

Postoperative

  • a lack of medical expertise to manage common postoperative medical complications
  • a lack of involvement of expertise in rehabilitation and goal setting
  • a lack of expertise in discharge planning and accessing appropriate community services
  • a lack of expertise in communication with patients and carers regarding medical, geriatric and functional issues

Having read a summary of the traditional surgical pathway and discussed some of what you believe to be its benefits and drawbacks, how does this list compare with your own from the previous step? Do you disagree with any of the points raised?

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This article is from the free online course:

Perioperative Medicine in Action

UCL (University College London)

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