668 Introduction of a Pre-Operative Assessment Clinic for Elective Procedures in a Renal Replacement Therapy Unit - Analysis of Effect on Cancellation of Procedures

Abstract Aim In September 2020, our Renal and Transplant unit introduced a new formalised protocol for Pre-Operative Assessment Clinics (POACs), led by SHO-grade junior doctors. This study aims to investigate the efficacy of protocol. Method All elective operations including dialysis access procedures, transplant urology, parathyroidectomies hernia repairs conducted single renal replacement therapy were examined over an 18-month period prior POAC implementation, then 12-month following implementation. Living donor transplants nephrectomies excluded. On-the day (OTD) cancellation causes analysed categorised into: Results Total cases performed: Pre-implementation = 921, post-implementation 415. OTD cancellations: - total 211/921 (22.9%). 90 (9.8%) due predictable patient factors, 54 (5.9%) unpredictable factors 67 (7.2%) hospital factors. Post-implementation 58/415 (11.6%). 32 (7.7%) 12 (2.9%) Four (1%) cancelled two patients presenting with hypertension. Conclusions Patients failure have multiple co-morbidities. Optimising pre-operative care is crucial ensure they receive timely treatment. audit has demonstrated that redesigned reduction rates from 22.9% 11.6%, marked in cancellations. Further improvements re-audit are planned.