Skip to 0 minutes and 10 secondsThe future has arrived-- the future's just not evenly distributed, I think is a rather pithy statement. The future is all about ironing out the inequalities in health care for surgical patients. So I think the future is looking at chronic disease management, treating it, and optimising it, giving some ownership back to the patients to encourage healthier lifestyles so that length of stay is better, shorter, and hopefully the patients come out with an intervention to help them get better but stay better for the rest of their life-- not just pre-surgery. A more team-based approach.

Skip to 0 minutes and 48 secondsI think we'll be moving away from the models of the patient being the surgeon's patient where they have the overall decision as they look after the patient to-- a whole multidisciplinary approach. I'm going to be quite controversial, and I'm going to say that perioperative medicine is probably going to die down in about five years time for elective patients because, I think, perioperative medicine is about optimising the patient to make sure that they get through their surgery in the best possible way. But that will become the standard. However, for emergency patients, perioperative medicine hasn't been touched yet. So I think that, actually, the future of emergency perioperative medicine is just starting. Glorious.

Skip to 1 minute and 33 seconds[LAUGHTER] The future of perioperative medicine, I think, is very much going to be around collaborative working between specialties collaborative education and training, and upskilling the whole of the workforce to ensure that we've got a workforce that can provide good quality care to the majority of our patients-- which are older patients. The future of perioperative medicine is many, many ways is the future of anaesthesia, because I think if we simply stick to what we've been good at doing for more than a century-- which is the safe administration of anaesthesia in the operating theatre-- our specialty has a very limited lifespan.

Skip to 2 minutes and 14 secondsAnd I think we need to embrace the broader physician role of looking after the patients that have that at the centre of their care journey but even have a much bigger care journey around them. So moving risk assessment far, far further forward in the treatment pathway. When a patient comes to the GP with knee pain, we should immediately be thinking about that the lifestyle modifications that might help them, not just optimise them potentially for surgery, but actually might help avoid that risk of an operation altogether.

Skip to 2 minutes and 44 secondsSo trying to streamline the way in which we help patients to optimise their health as well as their health care, and working across treatment boundaries-- so primary care, social care, and secondary care all working together to try and bring together all the different elements that comprise a really high quality patient pathway in order to improve patient outcomes. Better information about how patients do so we can give them accurate predictions, I think increasing awareness that they're decision is the right one, whatever it is.

Final thoughts

You have now reached the end of Perioperative Medicine in Action: congratulations!

We would like to thank you for joining us on this journey. We hope you have found it enjoyable and educational, and that it will inspire you to change and improve perioperative outcomes in your healthcare settings.

You have learned an extraordinary amount over the last four weeks. Looking back at the course aims you should now be able to:

  • Justify the need for better, more holistic care for the high risk surgical patient, to improve outcomes and reduce healthcare costs
  • Engage with risk assessment tools to characterise and quantify the risk of an individual undergoing a particular procedure
  • Demonstrate the need for protocolised care pathways and evaluate the success of the enhanced recovery programmes in reducing variance in practice
  • Describe the major challenges in delivering perioperative medicine for the elderly
  • Discuss the current economic pressure on healthcare systems and how perioperative medicine can be used to reduce these pressures.

As your Lead Educators, we firmly believe that by embracing perioperative medicine we can provide higher quality care for high risk patients, despite current financial pressures. Because of this, we believe that the future for perioperative medicine is extremely bright and it’s journey is just beginning.

Finally, we would ask you to watch the video to see what our expert faculty believe is the future of perioperative medicine. As ever, we would love to hear your thoughts in the comments section.

We’d like to understand what people gained from the course and what could be improved for the future, so if you are able please complete the post-course survey. We would also like to stay in touch with you, our perioperative medicine community, and occasionally send you updates as the perioperative medicine field develops. If you are interested in this please follow this link.

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This video is from the free online course:

Perioperative Medicine in Action

UCL (University College London)