Ken Sleeman has been practising medicine as an anaesthetist for over 50 years. Spending most of his time as a Consultant Anaesthetist at The Alfred and in private practice, he recently “semi-retired” to the Sunshine Coast where he has been involved with the Sunshine Coast University Hospital and developing a Clinical Quality Registry for the outcomes of day care anaesthesia, the DayCOR Registry (www.daycorregistry.com.au).
Initially developed whilst he was chairman of the Anaesthesia Continuing Education (ACE) Day Care Anaesthesia Special Interest Group (SIG), DayCOR has now surveyed over 130,000 patients with a current 87% response rate. The survey, sent to each patient by text and email 24 hours post discharge, has 15 questions which can be answered in 2-3 minutes. Very importantly, it contains questions for positive and negative comments as well as suggestions. With a free hand and no check boxes, patients are able to express themselves fully and fulfil the otherwise rigid demands of “PROMS” and “PREMS”.
A recent innovation is to include an assessment of frailty: the Clinical Frailty Scale (CFS) developed by Rockwood in Canada in 2005. This scale provides an extremely useful summary and indication of the degree of frailty. As frailty is now being regarded as a more accurate predictor of outcome rather than clinical indices of co-morbidity, the CFS should become an especially useful tool. Further, if a major surgical procedure is required, frailty assessment for the initial investigatory procedure will provide evidence for Prehabilitation.