Developing the Prehabilitation and Early Follow-Up Pathway for the Awake Craniotomy Service at Royal Stoke University Hospital

AIMS A pathway was developed to optimise patient preparation, intraoperative monitoring, and post-operative re- habilitation for awake craniotomy patients. This ensures comprehensive neurosurgical, neuropsychological, neurological, physiotherapy, and nursing support tailored to cognitive, emotional, and functional needs, en- hancing surgical outcomes and patient experience. METHODS A multidisciplinary team prepares patients medically, practically, and psychologically before surgery, conduct- ing cognitive and physical assessments to identify strengths, impairments, and rehabilitation opportunities. During surgery, neuropsychologists monitor cognitive function, and physiotherapists assist when motor as- sessment is required. Post-operatively, an inpatient assistant psychologist provides early follow-up to address immediate needs, while a physiotherapist reviews patients within 24 hours. Speech and language therapy is provided as necessary, and the assistant psychologist coordinates with the Clinical Nurse Specialist and other MDT members. Neuropsy- chology follow-up is scheduled at 1, 3, 6, and 12 months post-surgery, with enhanced pathways for patients needing further psychological therapy or cognitive rehabilitation. Outpatient rehabilitation referrals are made as required. Patient satisfaction surveys inform ongoing service improvements. RESULTS Satisfaction data highlighted high overall satisfaction but identified inpatient challenges, leading to the intro- duction of an assistant psychologist, improving ward experience. A lack of written information was addressed with a video leaflet. Key findings (Jan–Dec 2024): -100% (23/23) felt well cared for during surgery. -100% (20/20) found early follow-up sessions helpful. -100% (23/23) felt psychologically prepared for surgery. CONCLUSION The pathway has enhanced patient preparation, intraoperative assessment, and post-operative care. Integrat- ing inpatient psychological support and specialised clinics has improved patient experience and rehabilitation. Ongoing data collection will refine the service, ensuring optimal care and outcomes.