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Streamlining elective surgical pathways using early digital screening with complexity grading: feasibility study of a
Tom Langford1, Daveena Meeks2, Deirdre Anderson3
1Centre for Innovation, Transformation and Improvement, Guy's and St Thomas' NHS Foundation Trust, London, UK tom.langford1@nhs.net.
BMJ Health & Care Informatics
|July 20, 2026
Summary
A new digital questionnaire for elective surgery patients significantly speeds up preoperative screening, reducing it from weeks to days. This tool is feasible, user-friendly, and accurately identifies patient complexity for streamlined care.
Area of Science:
- Surgical patient assessment
- Digital health tools
- Preoperative care optimization
Background:
- Early complexity screening is crucial for elective surgery patients.
- Current screening methods can be time-consuming.
- Streamlining triage improves patient pathways.
Purpose of the Study:
- To assess the feasibility, usability, and validity of a co-designed digital questionnaire.
- To evaluate the tool's effectiveness in early complexity screening for elective surgery.
Main Methods:
- A mixed-methods feasibility study.
- Utilized operational data, patient interviews, and surveys.
- Included a nurse-led validation process.
Main Results:
- Preoperative screening time reduced from 3-4 weeks to 3.4 days.
- 44% of patients were eligible for fast-tracking.
- Nurse validation achieved 100% accuracy for medium and high-complexity cases.
- 97% of patients completed the questionnaire with ease.
Conclusions:
- The digital questionnaire is feasible, user-friendly, and valid for early complexity screening.
- The tool enables earlier complexity identification and streamlines patient triage.
- Potential to reduce cancellations and facilitate prehabilitation.