The People Behind The Numbers

Author: Mitalee PisavadiaDate: 8 months 4 days Ago

You see it in the movies, you read about it and you think you know what to expect when you’re in that operating theatre, but real life is nothing quite like what you see on Grey’s Anatomy. I had the wonderful privilege of observing a surgery during my placement with the Leeds Teaching Hospitals NHS Trust’s (LTHT) Costing Team to gain some insight into patient pathways and how the data we analyse is derived.
As a Health Analysis Graduate Trainee working with PLICS (Patient Level Information Costing System), I work with masses of clinical and financial data; however, the numbers only tell you part of the story. Spending just half a day in the clinical world has given me insight into patient pathways, patient safety, how data is recorded and the patient experience. Dr. Alwyn Kotze (Consultant Anaesthetist) very kindly organised a theatre shadowing opportunity for me. Although observing a surgery was always something I wanted to do, it was an incredible opportunity to gain an understanding of the clinical and patient facet of the financial data I analyse and interpret daily in my current role.

So, on the day, I got changed and made my way to meet with the theatre team feeling like a complete imposter in scrubs. The theatre session list for that morning comprised of three surgeries and I was going to be observing a lower back (L4/L5) spinal decompression. It was interesting to observe the various complexities involved behind the scenes, such as while theatre lists are ordered chronologically, this may not always be clinically appropriate. I also noted the need for communication between the theatre teams and the wards to ensure that beds are available for patients after their surgery. Alwyn mentioned the need for a central IT system that is shared between these teams which would ensure effective communication and planning to allow an efficient patient pathway. This can also have an implication on a patient’s experience. For example, a patient who is due to be operated on later in the day could arrive at the hospital later and not have to wait long hours. There is much talk about the need to digitise pathways within the NHS but seeing the need for it in a practical context and how it could truly drive improvements to patient experience and pathways really puts it into perspective.
I was then able to accompany Alwyn to meet our patient to go over their details and the procedure. Undergoing surgery can be a daunting experience for many patients who can feel quite vulnerable as they are essentially putting their lives in the hands of surgeons. Alwyn was amazing at putting the patient at ease and said that his sole duty was to look after them. Being able to witness this interaction was a humbling experience and reminds those of us who don’t work as closely with the frontline that there are real patients behind the data.
I was then able to see the entire patient pathway from when the patient was anaesthetised to when they regained consciousness in recovery. I was also able to see the various protocols that have been implemented to ensure patient safety. For example a team brief was held at the start of the day where everyone in the theatre team introduced who they were and what role they played and to ensure that all the necessary equipment required was working. At various stages before the surgery took place, the patient was asked to confirm their details i.e. name, date of birth, what procedure was taking place, site of the operation, allergies etc. Even after the patient had been anaesthetised, a “surgical time out” was held to once again confirm their details. Although this may feel repetitive, these protocols have been put in place to prevent disastrous outcomes (never events) that have occurred in the past where the wrong patient or the wrong surgical site have been operated on.
It was an amazing experience to be able to observe the surgery. The surgeons were kind enough to allow me to come closer so that I could visualise the anatomy but making sure not to break the sterile field and there I could see it, the bony vertebrae that makes up our spinal column. It was surreal.
Once the surgery was completed the patient was transferred to the recovery room where the nurses closely monitored the patient. The nurses referred to the various beeping noises from the monitors as their ‘music’.  
Working as an analyst there are often various degrees of separation from the frontline and can at times feel detached from the patient. Shadowing opportunities like these have helped to reaffirm the importance of my role and how I can influence and improve patient care. It certainly gave me a better appreciation of the challenges encountered by staff on the frontline and how in the face of such challenges their dedication to patient care remains unwavering.

A massive thank you to my Costing Team and Dr. Alwyn Kotze for organising such a valuable experience. This certainly won’t be my last venture into the clinical world and would absolutely recommend others to seek out similar opportunities.