Abstract Rationale Traditional respiratory referral pathways in cardiac surgery can prolong surgery wait times for patients. This abstract compares timelines between traditional respiratory pathway against a specialist nurse-led respiratory pathway. Could this streamlined service be the new gold standard for respiratory assessment in cardiac surgery? Methods Traditional respiratory referral pathway at St George’s University Hospitals (SGH), was compared with the streamlined nurse-led respiratory pathway (Madden et al. 2025). Previously, referrals for respiratory review and optimisation were initiated via a dictated letter by a cardiac surgeon. This was outsourced for typing and reviewed for approval by the referrer before being sent to a department triaging queue. Once received, a respiratory clinician reviewed and proposed further investigations for the patient. Recommendations were dictated, sent to the surgeon and the cycle continues until a plan is made. In the nurse-led respiratory assessment pathway baseline assessments were performed (history taking, lung function). Nurses then reviewed abnormal results face-to-face with a respiratory consultant, and further investigations were requested and escalated to avoid delay (Madden et al. 2025). Results The traditional referral pathway at SGH took around 2-3 months, from initial consultation with a cardiac surgeon to surgery. If further respiratory investigations were required, this added a further 2-3 months before a management plan was finalised. Delays to surgery are associated with worsening patient clinical condition, affecting patient safety and experience. In comparison, the nurse-led respiratory assessment pathway dramatically reduced this timeframe to around one month. If further investigations or reviews were required, the nursing team were able to organise promptly within an additional month (Madden et al. 2025). This pathway facilitated quicker decision making and creation of bespoke management plans. Conclusions A specialised nurse-led respiratory pathway drastically streamlined pre-operative decision making, reducing delays to surgery and facilitating bespoke management plans. This pathway has shown to cut the ‘red tape’ associated with healthcare, promoting efficiency. Patient and staff have benefited from this streamlined service, improving patient safety and staff well-being. Following successful integration of this model at SGH, our experience suggests that this pathway has broad and beneficial applications for respiratory assessment in cardiac surgery and may potentially be applied to other specialties. References Madden, A., Bowles, C., Norton, H., Alarilla, V., Zafar, M., Madden, B. P., (2025). The Expanding Role of Nurse-led Pre-operative Clinics for Respiratory Assessment, Management, and Optimisation of Elective Cardiac Surgical Patients. American Journal of Respiratory and Critical Care Medicine. 211. A2982. This abstract is funded by: Cardiothoracic Surgery Department, St George’s University Hospitals NHS Foundation Trust
Alarilla et al. (Fri,) studied this question.