Elective Surgery Improvement Projects


ACI Surgery and Anaesthesia Team


Following the announcement from National Cabinet on 25 March 2020, NSW Health postponed non-urgent elective surgery to free capacity in hospitals, preserve personal protective equipment and ensure workforce safety and continuity.

Moving to resume these critical services presents an opportunity to rethink the way surgery is organised, furthering our efforts to shift from volume to value and from outputs to outcomes.

The NSW Health Elective Surgery Roundtable was hosted by NSW Health on behalf of the Minister for Health and Minister for Medical Research on 9 July 2020. The forum was a system-wide and collaborative workshop, with experts from the public and private sectors working together to deliver the outcomes that matter most to patients waiting for elective surgery.

The roundtable brought together expert clinicians, health service managers and executives. The ambition for the day was to identify:

  • challenges to delivering the additional surgery required to manage the surgical backlog associated with the impact of the pandemic
  • successful strategies for building surgical capacity
  • actionable recommendations for implementation.

These discussions led to the development of eight ‘Big Ideas’ for change in surgical services, with an action plan to address various elements of the ideas created to support next steps.

The Agency for Clinical Innovation and Surgical Services Taskforce will be leading the following initiatives from the roundtable:

Enhanced Recovery After Surgery Developing and trialling a state-wide Enhanced Recovery After Surgery model. The model will apply to colorectal surgery initially, with a view to expanding the scope to other procedures / specialties in future.

Enhanced recovery after surgery: key principles for colorectal surgery, elective surgery action plan
Non-beneficial Surgery Developing a position paper and guidelines on non-beneficial surgery or surgery not supported by evidence.

Models of care

Enhanced Endoscopy Models of Care Reviewing evidence in literature around enhanced models of care for endoscopic procedures to provide recommendations for NSW Health on next steps.
Centres of Excellence Reviewing evidence in literature around consolidating specialty services into ‘centres of excellence’, assessing the value of these models and making recommendations to NSW Health on next steps.

Reviewing evidence in literature and local examples of prehabilitation models.

Developing prehabilitation protocols and trialling them at select sites.

Value Based Care/Low Value Surgery

Identifying procedures that in particular patient cohorts or clinical presentations, offer little to no benefit to the patient based on current peer reviewed evidence. This identification should be evidence-based, with the ‘opportunity cost’ permitting more clinically appropriate procedures to be performed in public hospitals. The goal is to identify and establish an agreed clinical governance process around low value surgical procedures.

To get involved in a project, let us know how you’re tackling these topics in your hospital, or to stay up to date on this project’s progress please contact the ACI Surgery & Anaesthesia Team. We would love to hear from you!


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