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Care Opinion

Day surgery communication

Posted By HungryGrouch

"Day surgery communication"

About: Albany Health Campus / Surgical Ward

(as the patient),

I was turned away from a routine colonoscopy procedure recently.  There is a long waiting list for this procedure so it may be a long time before I get in again. The preparation is inconvenient and uncomfortable and shouldn't be repeated unnecessarily.  

I knew that being on blood-thinning medication was a complication for surgery so I was particular to inquire of my General Practitioner (GP) (as per WACHS instructions) and the Anaesthetist who advised that not taking the dose the night before was appropriate.  

I went through the 4 days preparation, consisting of a low fibre reduction diet for 72 hours, liquid-only diet for 24 hours and fasting for 16 hours prior to admission. I consumed the 3 litres of laxative liquid and did not take my blood thinning medication after 28 hours prior to admission.

I re-arranged my affairs to avoid commitments for all of the day of the surgery, so I was very annoyed to be told that the Duty Surgeon insists on 48 hours abstinence of blood-thinning medication prior to surgery.  This should be a fairly standard and well-communicated requirement. It is very frustrating to go through all the required consultations with GPs and the Anaesthetist and the inconvenient, uncomfortable dieting, to say nothing of costs to myself and the health system, to hear at the eleventh hour that the Surgeon doesn't want to proceed because the higher bar was not achieved.

The surgery was running late so I believe that at least they would be happy to have one less procedure to perform.

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Responses

Response from Juan Clark, Operations Manager, Operations, Albany Health Campus, WACHS Great Southern 4 years ago
Juan Clark
Operations Manager, Operations,
Albany Health Campus, WACHS Great Southern

Submitted on 14/08/2019 at 1:45 PM
Published on Care Opinion at 2:52 PM

Dear HungryGrouch,

You are absolutely correct, preparing for colonoscopies is not a pleasant process and I am very sorry that your procedure was cancelled, despite your diligent preparation.

In order to investigate your feedback comprehensively and to learn from your experience, particularly with regards to the mixed messaging around halting your blood-thinning medication, would you consider contacting us directly on 9892 2620? We will then be able to ask one of our surgical team to review your case and provide you with a more comprehensive response to your feedback.

I am very sorry for the inconvenience that this has caused you and hope that your procedure has been rescheduled.

With best wishes.

Juan Clark

Albany Health Campus Operations Manager

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Response from Juan Clark, Operations Manager, Operations, Albany Health Campus, WACHS Great Southern 4 years ago
We have made a change
Juan Clark
Operations Manager, Operations,
Albany Health Campus, WACHS Great Southern

Submitted on 2/09/2019 at 3:06 PM
Published on Care Opinion at 3:42 PM

Dear HungryGrouch,

Thank you for telling us your story and giving us the opportunity to review our processes around day procedures such as colonoscopies. I am glad to hear that your appointment has been rebooked for the coming weeks and I reiterate my apologies.

You have raised a number of issues both in your original post and in a subsequent phone conversation with one of my colleagues so I hope I answer those issues adequately below.

Firstly, you asked if there was a communication breakdown between the various doctors involved in your care. The short answer is yes, but it was exacerbated by the retirement of your GP from our service and the subsequent transfer of your care to one of our Consultant Surgeons.

We were aware of the potential for some miscommunication due to this retirement and had put in place a process to decrease the risk of the cancellation of patients on the day of their surgery that involved offering all patients a pre-admission appointment with the Surgeon. This would also have picked up any issues with the timing of ceasing medication prior to surgery. It seems in your case this did not occur.

We have in recent weeks significantly reviewed our administrative processes around patients undergoing colonoscopies that include not only the recommendation of a pre-admission consult with the Surgeon but also standardisation of pre-admission documentation provided to our patients. The surgical services team have discussed your feedback and have endorsed that it will be our Surgeons who are responsible for providing key information, particularly with regards to medication, to our patients.

You expressed disappointment that you were informed of the cancellation of your surgery in a location that did not show due consideration for your privacy and confidentiality. Whilst the conversation occurred in one of the pre-surgery bays we acknowledge that you feel this did not offer sufficient privacy and are continuing to discuss how we can improve in this area.

It is really important for you to know that the sole reason for the cancellation of your colonoscopy was based on clinical grounds, with your safety and wellbeing forefront in the decision. There were no other considerations, least of all administrative.

Once again thank you for sharing your story and please contact us if you require anything further.

Best wishes,

Juan Clark

Operations Manager, Albany Health Campus

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