Are Patients Requiring Hartmann's Procedure Being Adequately Optimised for Surgery: An Audit Cycle

Area of Science:

• Colorectal Surgery
• Surgical Patient Optimization

Background:

• Hartmann's procedure is a major surgery for various colon conditions.
• Pre-operative anemia is linked to increased patient morbidity and mortality.
• Optimizing hemoglobin levels pre-surgery is crucial for patient outcomes.

Purpose of the Study:

• To assess patient optimization prior to Hartmann's procedure.
• To evaluate the impact of an intervention on pre-operative anemia and blood test completion.

Main Methods:

• Retrospective analysis of patients undergoing Hartmann's procedure (May 2016 - Feb 2020).
• Data collected included American Society of Anesthesiology (ASA) grade and pre-operative hemoglobin levels.
• Intervention involved flowchart poster distribution and proforma addition.

Main Results:

• Pre-intervention: 21% of patients had hemoglobin <12 g/dL; 90% had group and save tests.
• Post-intervention: Anemia reduced to 11%; group and save test completion increased to 97% (in a subset of patients).

Conclusions:

• The implemented intervention significantly improved patient optimization before Hartmann's procedure.
• Enhanced pre-operative management can reduce anemia and improve preparedness for major colorectal surgery.