Exploring challenges and solutions in the preparation of surgical patients.

Introduction: Handover of surgical patients from ward to operating room is a sensible point for information and communication failures. Guidelines were developed for preparation of surgical patients. Our aim was to explore if patients are sufficiently prepared for surgery according to local guidelines and to identify challenges and solutions for correct preparation through interactive table simulation-based workshops involving the various professions and specialties. Methods: Firstly, specific tasks in the hospital guidelines were monitored for all surgical procedures during one week. Secondly, workshops including table simulations involving the various professions and specialties were held. Results: In total, 314 surgical procedures were performed of which 196 were eligible for analysis. Emergency procedures showed the poorest results with non-completed tasks comprising 58% of electronic patient management system tasks, 26% of anaesthesia record tasks, 24% of medication tasks, 14% of blood test tasks and 12% of patient record tasks. In two workshops held for each of four specialties, a total of 21 participants mapped the preoperative patient journey with related responsibilities, tasks and written documentation. Furthermore, challenges and suggestions for solutions were identified. Conclusions: Completion of mandatory tasks for surgical patient preparation was poor. Workshops with table simulations actively involved the stakeholders from various professions and specialties in describing the patient trajectory and mandatory tasks according to hospital guidelines in addition to identifying challenges and solutions for improvement.