Our Best Care guidance provides evidence-based information for Victorian healthcare professionals in relation to specific elective surgical procedures which can only be performed under certain circumstances or at certain time intervals.
The Best Care guidance aims to:
- inform clinicians about what is considered best care pathways in relation to specific surgical procedures based on the latest evidence
- support clinicians and their patients to discuss available options and make informed healthcare decisions together
- empower Victorians to feel well informed about the best management of their healthcare needs.
This information is for clinicians from primary healthcare settings through to acute healthcare services. Patients and their carers can access a consumer version of the Best Care guidance on the Better Health Channel.
What is Best Care about?
To align with recent elective surgery reform, these procedures can now only be performed in circumstances where the procedure is indicated (as outlined in the guidance) or for whom an exemption for the procedure has been sought and approved at a local health service level.
The department is currently formalising this direction into relevant policy documents.
The decision to perform the surgery must be shared between the clinician and patient. The surgical referral must include documentation of a joint discussion between clinician and patient considering:
- the clinical evidence
- the individual risks and benefits of the procedure
- the health outcomes that matter to the patient
- available alternative care options.
Why did we do this?
During the first wave of the coronavirus (COVID-19) pandemic in Victoria, all non-urgent elective surgery was temporarily suspended. This decision was made so that health services could conserve personal protective equipment (PPE), minimise the risk of infection to staff and patients, and ensure intensive care unit capacity for coronavirus (COVID-19) care.
During this period, Safer Care Victoria partnered with the Victorian Perioperative Consultative Council to review the clinical evidence for surgical procedures.
A list of specific surgical procedures have been identified as having limited evidence of clinical benefit for patients except when specific clinical indications exist.
Acknowledgements
There are many people who contributed to the Best Care work from its inception through to publication. Prior to the Best Care guidance process being endorsed, members of the Victorian Perioperative Consultative Council and the Peri-Operative Expert Working Group, including clinicians called upon for specific expertise, were instrumental in bringing together the original Best Care elective surgery procedures list and we acknowledge their contributions.
We wish to acknowledge the many people who contributed to the Best Care guidance work from writing and reviewing content, providing expert clinical opinion, undertaking literature reviews and providing feedback throughout consultation.
In particular, we wish to acknowledge the significant contributions made by the following people and groups:
- Best Care Best Place Taskforce
- David Watters
- Charlotte Elder
- Mikhaila Lazanyi
- Eric Levi
- Deborah Amott
- Wendy Brown
- Susan Shedda
- Jon Emery
- Marinis Pirpiris
- Melanie Walker
- Michael Johnson
- Peter Hand
- Mathew Hadfield
- Safer Care Victoria’s Consumer Leadership Reference Group
- Jen Morris
- Shu-Yi Soong
- Bridget Clancy
- Libby Rose
- Eliza Tweedle
- Bernard Shiu
- Sarah O’Leary
- Mark Ashton
- Dan Kennedy
- Michael Permezel
- Andrew Hardidge
- Peri-Operative expert working group
- Simon Purser