Perioperative Quality Initiative consensus statement recommendations on the definition, development, implementation and outcomes of pre-operative surgery schools.

Introduction

Pre-operative group sessions incorporating patient education and behaviour change interventions, known as 'surgery schools', are becoming increasingly common before major elective surgery across the world. However, there is a lack of conclusive evidence regarding the effectiveness of surgery schools, and the development and delivery of these complex interventions lacks standardisation.

Methods

In collaboration with the Perioperative Quality Initiative, we aimed to develop evidence- and expertise-based consensus statements and recommendations regarding the definition, design, content, and outcomes of surgery schools. Thirty-two international multidisciplinary experts in surgery school and pre-operative preparation attended a series of virtual meetings based on a modified Delphi methodology. A systematic review and additional targeted literature searches were used to propose statements for the definition, design, content and outcomes of surgery schools. Statements and recommendations were discussed iteratively and refined in multiple rounds, until agreement was reached.

Results

Consensus was reached on a definition of surgery school, as well as three statements and 18 recommendations in relation to: scope; outcomes; intervention development; delivery; inclusivity; and educational content of surgery schools. Seventeen areas were highlighted as priorities for future research.

Discussion

These consensus statements and recommendations are intended to help clinicians and service managers who plan to develop and implement surgery schools. They may improve the quality of those programmes and help to standardise their content. We also hope that this work will influence government strategy and policy in relation to the design, delivery and funding of peri-operative optimisation pathways.

Before big, planned operations, many hospitals now run special group classes called ‘surgery schools.’ These help patients learn what to expect and how to get ready for their operation. But doctors still don't know for sure how well these classes work, and there is no clear guide as to how they should be set up. To help fix this, a group of experts from around the world worked together. They wanted to agree on what surgery schools should look like and what they should teach. They met online in meetings and looked at lots of studies and research. They talked through ideas in several rounds until they all agreed on the best advice. The team agreed on a definition of what a surgery school is and produced 21 pieces of advice about how to plan and run these schools. These included what should be taught, how to make the classes easy for everyone to join and how to deliver them well. They also found 17 topics that need more research. These new ideas can help doctors and hospital staff create better surgery schools. This might make the classes more useful and more similar across different hospitals. The team also hopes their work will help guide health leaders when they make rules and decisions about these programmes.