680 Excelling in Adversity - Maximising Training Opportunities by Reducing Cancelled Operations

Aim Viral swabs for Covid-19 are an essential part of a patient’s pre-operative checklist. Patients require negative swabs before proceeding to theatre. Delay in this process may lead to a cancelled operation with physical and mental health implications for the patient. There is a knock-on effect on surgical training, with fewer procedures and operations for teaching. Method Previous guidance required 2 staggered swabs prior to admission. This was simplified on 19th August 2020 to a single pre-operative swab. A retrospective audit was established within the Otolaryngology department at the Royal Gwent Hospital to assess whether the simplification of guidance reduced the rate of cancellations and the number of same-day swabs needed to maintain operating. Results In a 4-week period prior to the simplification in guidance there were 34 listed procedures, 3 of which were cancelled due to swab related issues. 1 patient required a same-day swab to facilitate surgery. In a 4-week period after the simplification in guidance there were 48 listed operations and no cancellations due to swab issues. 6 patients required same-day swabs to facilitate surgery. Conclusions Whilst the simplification of swab guidance has improved the rate of operations cancelled, the reliance on same-day swabs to maintain operating has increased. This could reflect better availability of same-day swabs. It is in the interest of trainees to ensure that patients are fully prepared for operations pre-operatively to minimise unplanned cancellations, associated patient harm and loss of training opportunities.