Health Economics and Improved Perioperative Care

Massive transfusions are not confined to major teaching hospitals or to trauma centres – they can occur in many other settings. In this podcast, Dr Simon Hendel discusses the use of massive transfusions and massive transfusion protocols. In particular, he explores the issue of pre-hospital resuscitation and how a massive transfusion protocol may be helpful even in a remote country hospital with limited resources.

In 2016, the WHO made a strong recommendation that certain patients should have 80% oxygen administered in the immediate postoperative period for 2-6 hours to decrease the risk of surgical site infection. Prof Paul Myles discusses the reasons this recommendation disturbed him and his subsequent actions.

Dr Brian Chen discusses common Postoperative Pulmonary Complications and their impact on patients and the health care system. He explores risk predictors and key perioperative prevention measures. An important topic for all perioperative clinicians.

In this episode, Dr Olivia Leahy talks to Dr Harry Sivakumar (Anaesthetist and Pain Specialist) and Dr Martyn Lloyd-Jones (addiction medicine specialist) about buprenorphine, an opioid analgesic used in the management of acute and perioperative pain, and selectively in chronic pain, as well as in opioid replacement therapy.

Dr Jonathan Nicholson asks Dr Justin Burke how to safely navigate patients taking SGLT2 inhibitors through the perioperative period. Clinical dilemmas are discussed and practical guidance provided with discussion involving recent publications on detection, prevention and management of euglycaemic ketoacidosis.

Interview with Dr Kym Jenkins, president of the Royal Australian and New Zealand College of Psychiatrists. Discussion about the mental health of the medical professional. Recent medial coverage, what we know, common themes of unhappy doctors and future directions.

Dr Sarah Wilmot is a GP Anaesthetist in rural Victoria. For her Master of Perioperative Medicine Capstone Project, Sarah redesigned the pre-anaesthetic process in her practice in an effort to improve patient experience. She discusses her project, including the challenges she faced and the lessons learned when trying to bring about change. Note: this podcast was recorded earlier this year. At the time, Sarah had been recently diagnosed with a terminal illness. Despite feeling unwell she was keen to share her project with a wider audience. Tragically Sarah passed away last month. This conversation is shared in memory of Dr Sarah Wilmott and her dedication to the best care of her patients.

Burns can be a confronting and challenging clinical problem which present significant issues for the perioperative practitioner. In this episode, Dr Simon Hendel speaks with Dr Heather Cleland, consultant plastic surgeon and director of the Victorian Adult Burns Service at The Alfred Hospital, to gain insights into the diagnosis, management and prognosis of acute severe burns.

Professor David Scott discusses perioperative cognitive outcomes and why new nomenclature was needed.

Health economics is the branch of economics concerned with the costs, effectiveness and consumption of healthcare. Professor Danny Liew discusses why clinicians should give greater consideration to health economics, and the importance of using Real World Evidence in analysing the cost and value of perioperative interventions.