Streamlining elective surgical pathways using early digital screening with complexity grading: feasibility study of a co-designed innovation.

Langford, Tom; Meeks, Daveena; Anderson, Deirdre; Sepa, Lepalele; Fraser, Stephanie; Okeke, Pearl; Low, Joseph; Sinclair, Polly et al. · BMJ Health Care Inform · 2026

other · Level V

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Abstract

To evaluate the feasibility, usability and validity of a co-designed digital questionnaire for early complexity screening in elective surgery patients. A mixed-methods feasibility study was conducted using operational data, patient interviews and surveys. The average time to preoperative screening decreased from 3-4 weeks to 3.4 days. Of 244 patients, 44% were eligible for fast-tracking to low-complexity surgical hubs. A nurse-led validation process correctly identified 100% of medium-complexity and high-complexity cases. Most patients (97%) completed the questionnaire without assistance. The tool proved feasible and user-friendly, enabling earlier identification of complexity and streamlining patient triage. It also holds promise for reducing cancellations and facilitating timely prehabilitation. This feasibility study supports the tool's feasibility, usability and validity. Further research will assess its clinical, operational and health economic impacts within redesigned surgical pathways.

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