Abstract
Introduction
Peri-operative care of the Older Person undergoing Surgery (POPS) is an evidence-based multi-disciplinary intervention known to improve care and outcomes in older patients undergoing surgery. A POPS service has now been established in the Southwest Scotland Vascular Network (SSVN); to the best of our knowledge, the first of its kind nationally. We report our early experience.
Methods
SSVN opted to fund one whole time equivalent geriatrician using a vacant consultant surgeon salary. This has permitted the daily input of expert geriatricians for all patients over 60 in our service. This was a retrospective analysis of prospectively gathered data for all admissions to the SSVN unit from 1/10/2023 to 28/02/25. All incomplete data entries and day cases were excluded leaving 1186 data points for final analysis. We assessed key markers of care including hospital length of stay and antibiotic prescribing. We assessed for temporal trends associated with the start of the POPS service. Surveys of FY1 doctors over three different cohorts were also carried out anonymously through Google Forms. As this was a service evaluation project, ethical approval was not required.
Results
We showed an average reduction in overall ward length of stay in the target group and a significant reduction in the number of intravenous antibiotics prescriptions. Subjective surveys illustrate improved: peri-operative prescribing, management of delirium and diabetes and management of polypharmacy. All these improvements will translate into cost-saving and improved patient facing time for nurses. Subjectively, FY1 surveys showed that the vascular ward is now a more supported place for FY1s to work with a major perceived improvement in patient safety.
Conclusion
The introduction of a POPS service to the SSVN has been associated with very encouraging early results. We suggest that rolling out similar services in other Scottish Vascular units should be considered a priority in future service development.