Never before in the history of modern medicine has the world experienced a shutdown of elective surgical systems as was experienced during the COVID-19 pandemic, says Western University researcher Janet Martin.
An expert in global access to safe surgery, Martin and a team of experts from around the world have published a study in The Lancet that aims to help to improve resilience of hospitals against future surgical cancellations and backlogs worldwide.
Researchers developed and tested a new tool to help hospitals better prepare for "system stressors" that threaten surgical system performance and jeopardize planned procedures.
Janet Martin, professor in the department of anesthesia and perioperative medicine at Schulich Medicine & Dentistry
"The toolkit allows hospitals to take a systematic inventory of their staff, space, systems and supports in order to mitigate shocks such as epidemics, pandemics, natural disasters, and sudden supply chain interruptions," said Martin, a professor in the department of anaesthesia and perioperative medicine at Western’s Schulich School of Medicine & Dentistry. "This can be used as a metric of their preparedness to maintain resilient surgical services."
The ’Surgical Preparedness Index’ (SPI) assesses the extent to which hospitals around the world were able to continue elective surgery during the pandemic. Researchers identified different features of hospitals that made them more or less prepared for times of increased pressure.
They used COVID-19 as an important example but highlighted that health systems are put under stress for all sorts of reasons each year - from seasonal pressures, to natural disasters and warfare. A team of clinicians from 32 countries designed the SPI which scores hospitals based on their infrastructure, equipment, staff and processes used to provide elective surgery. According to the researchers, the higher the resulting score, the more prepared a hospital is for disruptions.
Since the tool was created, it has been applied by more than 4,700 clinicians in 1,632 hospitals across 119 countries to assess the preparedness of their local surgical departments. Overall, most hospitals were found to be poorly prepared, and suffered a big drop in the number of procedures they were able to provide during the pandemic.
"Without tools to identify our weaknesses and address our vulnerabilities to such system stressors in surgery and perioperative care, we will be at a loss to prevent this from happening again," said Martin.
James Glasbey, the paper’s lead author from the University of Birmingham said the hope is that the tool will also help hospitals to get through their waiting lists more quickly and prevent further delays for patients.
"The tool can be completed easily by healthcare workers and managers working in any hospital worldwide. If used regularly, it could protect hospitals and patients against future disruptions," he said.