As a perioperative physician, Prof Kesh Baboolal focuses on assessing and improving the health of patients who are due to undergo surgery. He also focuses on providing medical care after surgery to ensure a complete and uncomplicated recovery. Finally, Prof Kesh Baboolal works with a multidisciplinary team to identify and address the patient’s and family needs after surgery, such that a successful transition from hospital to home can be achieved.
To achieve this goal, each patient scheduled for surgery, is evaluated by Prof Baboolal to identify and manage any medical issues that may impact upon the successful completion and recovery from surgery. This information is then considered in the context of the complexity of the planned surgery. A comprehensive plan is created for each patient to optimise the health of the patient prior to, during, and after surgery including a safe and smooth discharge from the hospital.
To ensure the best care for patients, close communication is maintained between the perioperative physician, the surgeon, anaesthetist, GP and all other physicians involved with the patient’s care. These clinicians are made aware of any changes prior to or after surgery. In some circumstances, depending on the patient’s medical condition and the proposed surgery, specialist clinicians will play a direct role in the care of the patient. In addition, a comprehensive medical plan may include enlisting the support of rehabilitation clinicians, specialist nurse practitioners, and allied health staff including physiotherapists, occupational health clinicians, dieticians and pharmacists.
A number of factors are taken into account in the initial assessment including:
- the patient’s age
- body mass index (BMI)
- cardiac and respiratory health
- the presence of diabetes
- risk of infection
- risk of thrombosis
- other medical conditions
- adverse drug reactions and potential drug interactions
A review of investigations including blood tests, ECGs and X rays will be undertaken and incorporated into the patient assessment.
The surgeon and perioperative physician closely monitor the patient’s progress and recovery following surgery. Patients will also receive care from nurses and other multidisciplinary specialists as needed. Special attention is undertaken to ensure adequate pain control in the post-operative period. A major focus of the care for each patient is the development of a plan to prevent post-operative complications including deep vein thrombosis, pulmonary embolism, infections and side effects of pain medication. A number of medications and non-medical interventions are used to prevent these complications.
When a patient is ready to be discharged the perioperative physician works with nurses and case managers to ensure the patient’s needs are met and that discharge from hospital is safe and planned. This plan will include working with the patient and their family to identify services that may be required, helping arrange transport, communicating with GPs and other specialists and arranging follow up after surgery.