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Perioperative Quality Initiative consensus statement recommendations on the definition, development, implementation and outcomes of pre‐operative surgery schools

Perioperative Quality Initiative consensus statement recommendations on the definition, development, implementation and outcomes of pre‐operative surgery schools
Perioperative Quality Initiative consensus statement recommendations on the definition, development, implementation and outcomes of pre‐operative surgery schools

Introduction: pre-operative group sessions incorporating patient education and behaviour change interventions, known as ‘surgery schools’, are becoming increasingly common before major elective surgery across the world. However, there is a lack of conclusive evidence regarding the effectiveness of surgery schools, and the development and delivery of these complex interventions lacks standardisation. 

Methods: in collaboration with the Perioperative Quality Initiative, we aimed to develop evidence- and expertise-based consensus statements and recommendations regarding the definition, design, content, and outcomes of surgery schools. Thirty-two international multidisciplinary experts in surgery school and pre-operative preparation attended a series of virtual meetings based on a modified Delphi methodology. A systematic review and additional targeted literature searches were used to propose statements for the definition, design, content and outcomes of surgery schools. Statements and recommendations were discussed iteratively and refined in multiple rounds, until agreement was reached. 

Results: consensus was reached on a definition of surgery school, as well as three statements and 18 recommendations in relation to: scope; outcomes; intervention development; delivery; inclusivity; and educational content of surgery schools. Seventeen areas were highlighted as priorities for future research. 

Discussion: these consensus statements and recommendations are intended to help clinicians and service managers who plan to develop and implement surgery schools. They may improve the quality of those programmes and help to standardise their content. We also hope that this work will influence government strategy and policy in relation to the design, delivery and funding of peri-operative optimisation pathways.

Delphi consensus, peri-operative medicine, pre-operative education, surgery school, prehabilitation
0003-2409
1115-1133
Fecher‐Jones, Imogen
ab8373c5-3e2b-43cc-a3a1-3caa7240fbcb
Ainsworth, Ben
574c16aa-1598-4ff1-8268-9d59e0de7f11
Gan, Tong J.
3e877034-bb19-43e2-8dba-1d26059de9ec
Moonesinghe, S. Ramani
117f1e9b-1a63-4be2-b41c-e95dda807271
Shaw, Andrew D.
6690c15c-4ace-4fc1-9069-253feaa14fa3
Grocott, Michael P. W.
1e87b741-513e-4a22-be13-0f7bb344e8c2
Levett, Denny Z.H.
1743763a-2853-4baf-affe-6152fde8d05f
Perioperative Quality Initiative Surgery School Consensus Group
Fecher‐Jones, Imogen
ab8373c5-3e2b-43cc-a3a1-3caa7240fbcb
Ainsworth, Ben
574c16aa-1598-4ff1-8268-9d59e0de7f11
Gan, Tong J.
3e877034-bb19-43e2-8dba-1d26059de9ec
Moonesinghe, S. Ramani
117f1e9b-1a63-4be2-b41c-e95dda807271
Shaw, Andrew D.
6690c15c-4ace-4fc1-9069-253feaa14fa3
Grocott, Michael P. W.
1e87b741-513e-4a22-be13-0f7bb344e8c2
Levett, Denny Z.H.
1743763a-2853-4baf-affe-6152fde8d05f

Fecher‐Jones, Imogen, Ainsworth, Ben, Gan, Tong J., Moonesinghe, S. Ramani, Shaw, Andrew D., Grocott, Michael P. W. and Levett, Denny Z.H. , Perioperative Quality Initiative Surgery School Consensus Group (2025) Perioperative Quality Initiative consensus statement recommendations on the definition, development, implementation and outcomes of pre‐operative surgery schools. Anaesthesia, 80 (9), 1115-1133. (doi:10.1111/anae.16648).

Record type: Article

Abstract

Introduction: pre-operative group sessions incorporating patient education and behaviour change interventions, known as ‘surgery schools’, are becoming increasingly common before major elective surgery across the world. However, there is a lack of conclusive evidence regarding the effectiveness of surgery schools, and the development and delivery of these complex interventions lacks standardisation. 

Methods: in collaboration with the Perioperative Quality Initiative, we aimed to develop evidence- and expertise-based consensus statements and recommendations regarding the definition, design, content, and outcomes of surgery schools. Thirty-two international multidisciplinary experts in surgery school and pre-operative preparation attended a series of virtual meetings based on a modified Delphi methodology. A systematic review and additional targeted literature searches were used to propose statements for the definition, design, content and outcomes of surgery schools. Statements and recommendations were discussed iteratively and refined in multiple rounds, until agreement was reached. 

Results: consensus was reached on a definition of surgery school, as well as three statements and 18 recommendations in relation to: scope; outcomes; intervention development; delivery; inclusivity; and educational content of surgery schools. Seventeen areas were highlighted as priorities for future research. 

Discussion: these consensus statements and recommendations are intended to help clinicians and service managers who plan to develop and implement surgery schools. They may improve the quality of those programmes and help to standardise their content. We also hope that this work will influence government strategy and policy in relation to the design, delivery and funding of peri-operative optimisation pathways.

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Anaesthesia - 2025 - Fecher‐Jones - Perioperative Quality Initiative consensus statement recommendations on the definition .pdf - Version of Record
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Accepted/In Press date: 16 April 2025
e-pub ahead of print date: 21 June 2025
Keywords: Delphi consensus, peri-operative medicine, pre-operative education, surgery school, prehabilitation

Identifiers

Local EPrints ID: 504597
URI: http://eprints.soton.ac.uk/id/eprint/504597
ISSN: 0003-2409
PURE UUID: 01da6f60-b86c-4563-a1e6-6c9ae71a214e
ORCID for Michael P. W. Grocott: ORCID iD orcid.org/0000-0002-9484-7581
ORCID for Denny Z.H. Levett: ORCID iD orcid.org/0000-0002-8418-1675

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Date deposited: 16 Sep 2025 16:37
Last modified: 18 Sep 2025 01:57

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Contributors

Author: Imogen Fecher‐Jones
Author: Ben Ainsworth
Author: Tong J. Gan
Author: S. Ramani Moonesinghe
Author: Andrew D. Shaw
Author: Denny Z.H. Levett ORCID iD
Corporate Author: Perioperative Quality Initiative Surgery School Consensus Group

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