Victorian perioperative service capability framework

Professor David Scott, Chair, Victorian Perioperative Consultative Council: Hello, my name is David Scott, I’m a Specialist Anaesthetist and I’m the Chair of the Victorian Perioperative Consultative Council.

Professor David Watters, Director of Surgery, Safer Care Victoria: Hello, I’m David Watters, I’m Professor of Surgery at Deakin University and Barwon Health. And I’m also the Director of Surgery at Safer Care Victoria and lead the Perioperative Learning Health Network. 

Professor David Scott, Chair, Victorian Perioperative Consultative Council: The Perioperative service capability framework has been developed to support hospitals to provide safe high-quality perioperative care, at the right time, and importantly in the right place.  This covers care before, during, and after surgery.

Capability refers to the minimum level of care able to be provided including required workforce, infrastructure, equipment, clinical support and processes.

The framework outlines different levels for hospitals from one to six. Each level corresponds to a certain minimum standard for the support services, equipment, and the infrastructure that should be in place. This means that higher complexity surgeries, like cardiac procedures or neurosurgeries, should be performed at higher-level services such as Level 6.

The levels are based on surgical complexity and perioperative risk. This perioperative risk is based on the patient (the ASA status is used for simplicity) and the anaesthetic complexity as well.

Professor David Watters, Director of Surgery, Safer Care Victoria: The framework focuses mainly on planned surgery where decisions can be made in advance about the most appropriate facility for the patient, based on their needs, and the complexity of the procedure and/or the anaesthetic. It includes planned surgery for both adults and children.  

Professor David Scott, Chair, Victorian Perioperative Consultative Council: But it should be noted that emergencies should be managed on a case-by-case basis with either appropriate transfer if needed or the local provision of the best available care.

Professor David Watters, Director of Surgery, Safer Care Victoria: The framework is not just about support for clinical care in the operating theatre. 

So, how does this affect us as surgeons?

The framework will support surgeons to undertake procedures in facilities where the right resources are provided to support the staff to achieve the best outcomes for patients. 

It also supports clinicians to understand what should be in place at any given campus providing perioperative care and promotes transparency across the whole system. The aim is to enable safe and effective care as close to home as possible, and, when appropriate, to consider providing a higher level of care at a different facility.

Professor David Scott, Chair, Victorian Perioperative Consultative Council: 

How does this affect us as anaesthetists? 

The framework supports our practice, in being able to undertake procedures which the facility has the right resources to support.  It includes postoperative care, whether as day stay patients, on the ward or in HDU or ICU. It also ensures that all the resources you would expect are in place for when a critical event occurs unexpectedly. Finally, it is a useful tool to communicate with patients why a particular procedure may or may not be suitable to be undertaken at a given hospital campus.

Professor David Watters, Director of Surgery, Safer Care Victoria: I am pleased to support the release and implementation of this important Perioperative capability framework in Victoria.

Professor David Scott, Chair, Victorian Perioperative Consultative Council: I am pleased to support the release and implementation of this important framework in Victoria.