Episode #270 From Fears to Facts: Empowering Patients Before Surgery

Hello and welcome back to the Anesthesia Patient Safety Podcast. My name is Alli Bechtel, and I am your host. Thank you for joining us for another show. We are continuing to cover the excellent articles from the June 2025 APSF Newsletter. This week’s theme is the role of patient engagement in patient safety. Plus, we have exclusive content to go along with this article. We’ll be hearing from one of the authors as well as the patient representative on the APSF Patient Engagement Workgroup. So, stay tuned.

Before we dive further into the episode today, we’d like to recognize Draeger Medical, a major corporate supporter of APSF. Draeger Medical has generously provided unrestricted support to further our vision that “no one shall be harmed by anesthesia care”. Thank you, Draeger Medical – we wouldn’t be able to do all that we do without you!”

Our featured article today is “Patient Engagement: The Cornerstone of Patient Safety” by Maria van Pelt and colleagues. To follow along with us, head over to APSF.org and click on the Newsletter heading. The first one down is the current newsletter. Then, scroll down until you get to our featured article today. I will include the link in the show notes as well.

To help kick off the show today, we are going to be hearing from one of the authors. Let’s take a listen now.

[Maria van Pelt Clips] “ Hi, my name is Maria Van Pelt and I’m a CRNA, and I work as a clinical professor at Northeastern University and I practice at Massachusetts General Hospital. I’m here today to discuss our article, Patient Engagement, the Cornerstone of Patient Safety.

[Bechtel] I asked van Pelt why she wrote this article. Here is her response.

[van Pelt] “Through research and patient feedback, the work group found that patients consistently needed answers to key questions about anesthesia and surgery. Existing online resources rarely address these concerns adequately while medical journals provided detailed information. They used technical language that wasn’t accessible to patients.

This revealed a clear opportunity for the Anesthesia Patient Safety Foundation to create a patient-centered content area for our website. We hoped that this would empower patients to actively participate in shared decision making with their healthcare providers. This article highlights that the mission of this initiative extends beyond merely providing information.

It aimed to encourage patients to actively participate in their healthcare journey and to gain a better understanding of how they can minimize perioperative risk and complications. The ultimate goal is patient empowerment so that they are more involved in their care decisions and learn practical ways to mitigate their own risks.”

[Bechtel] Thank you so much to van Pelt for helping to introduce this topic. We talked about the Patient Guide to Anesthesia and Surgery on episode #254 and 255 and we hope that you will check out those shows and this incredible APSF resource geared for patients. We are excited to continue the conversation about the connection between patient safety and patient engagement. So, let’s get into the article.

Patient Engagement emerged as a priority for the APSF in 2022 as an important way to work towards improved anesthesia patient safety. This led to the creation of the APSF Patient Engagement Workgroup with patients and clinicians serving as members of the committee and working together. Using a multifaceted approach that included user-design principles, web analytics, and traditional review methodologies, the workgroup identified opportunities for the APSF to enhance patient education and engagement in anesthesia and surgical care.

The workgroup identified key patient concerns related to anesthesia and surgery including the following questions:

• Do I need to have surgery?
• What if I have trouble waking up from anesthesia?
• How many times is it safe to go under anesthesia?
• Are there long-term side effects of anesthesia?

These may be questions that patients ask you in the preoperative anesthesia clinic or the preoperative holding bay. Patients may have tried to find the answers online prior to their surgery, but search engine keywork search and analysis of high-ranking websites revealed that online content addressing these concerns was limited or incomplete. There are detailed and up-to-date medical journal articles that may have some of these answers, but these resources are not patient-centered and may be difficult to understand due to the use of technical language. The APSF recognized that there was an opportunity to create a resource that would not only address these patient concerns, but also empower patients to take ownership of their care and effectively participate in shared decision-making with their health care team.

So, what is this resource? You have likely guessed that we are talking about the Patient Guide to Anesthesia and Surgery. This APSF initiative was developed by patient advocates and anesthesia and surgery professionals to answer the most commonly asked questions before surgery. You can find this resource over at APSF.org. Then click on the Patient Safety Resources heading. Fourth one up from the bottom is the Patient Guide to Anesthesia and Surgery. I will include a link in the show notes as well.

Check out Table 1 in the article for the content overview for the Patient guide to anesthesia. The categories include Understanding Anesthesia, Pre-surgery Considerations, Risk Assessment, Post-surgery Pain, Pain Management, and Important Questions. These questions will be familiar to anesthesia professionals. You may have been asked one of these questions today. The good news is that you can direct your patients to the APSF’s Patient Guide for more information. The guide also includes a list of questions to ask your anesthesia professional and questions to ask your surgeon. These questions can help patients become active participants in their surgery and anesthesia care and work to help minimize perioperative risks and complications. The goal of this patient engagement initiative is patient empowerment so that patients can be more involved in care decisions and take practical steps to mitigate their own risks.

So, how did the APSF workgroup develop the Patient Guide? The guiding principle was to listen to patients and understand their fears, concerns, and informational needs in their own terms rather than based on what healthcare professionals think patients need to know. The first step involved comprehensive online patient surveys and in-depth interviews. The survey questionnaires were designed to help understand the main fears and concerns that patients have when it comes to anesthesia care. There was a diverse group of surveyed patient participants from different age, social, and ethnic groups using the Amazon Mechanical Turk or MT-URK platform which is an online marketplace that provides access to a demographically diverse participant pool beyond researchers’ immediate networks to help reduce potential selection bias. The next step involved snowball sampling to conduct in-depth in person interviews to explore patients’ and their families’ concerns further. The team used the Empathy Map developed by Dave Gray and XPLANE, which is a methodological tool to understand users behaviour. Check out Figure 1 in the article for a visual representation of the empathy map. The team used the empathy map to record what patients see, feel, think, and do in relation to surgery and anesthesia care as well as to discover perceived gains and losses related to these experiences. The team put these two steps together ion a priority topic list which served as the foundation for creating the initial content on the Patient Guide.

The workgroup took the priority topic list and designed a systematic process for content development that included accurate, accessible information that remained relevant to the patients’ needs. Each article followed a three-step review process including the following:

1. Initial drafting by a workgroup member with professional expertise in anesthesia who used readability assessment tools to create content at an 11th grade reading level or lower.
2. The first review was conducted by another workgroup member without professional expertise in anesthesia to ensure readability and relevance.
3. The final review was carried out by a professional writer to standardize the texts and ensure the quality, clarity, and consistency of the information.

The patient guide launched in October 2023. Since that time, there have been more than 82,000 page views by over 60,000 visitors. The Patient guide attracts over 10,000 visits each month and is one of the most-visited APSF resource. At the time of this article, the Patient guide accounted for 5 of the 10 most-viewed pages for the previous 6 months. Check out Figure 2 in the article to see the growth of this website since the launch. This is a really exciting resource for patients and anesthesia professionals who can direct their patients to this site for more patient-centered information and explanations.

Going forward, the Patient Engagement Workgroup has short and long-term strategic objectives. Here are some of the more immediate future plans:

Expansion of the content based on analytics and user feedback

Address additional high-priority questions identified through ongoing research

Longer term goals include the following:

More deeply integrating patient perspectives, lived experiences, and feedback into all APSF initiatives. Going forward, patient engagement may extend beyond educational content and have an important role in safety work, research priorities, and policy recommendations.

Develop strategic partnerships with other patient-focused organizations and foundations to amplify reach and impact.

Explore multimedia formats, interactive tools, and expanded language offerings to expand the accessibility of the content to a diverse audience.

We hope that you will check out the APSF Patient Guide to Anesthesia and Surgery and we hope that you will share this resource with other health professionals, patients, and families. We are working to ensure that patients remain the foundation for our patient safety focus. Patient-centered approaches and shared-decision making are not just nice added bonuses, these are essential components of safe anesthesia care now and going forward.

Before we wrap up for today, we are going to hear from van Pelt again. I also asked her, what do you hope to see going forward? Let’s take a listen to what she had to say.

[van Pelt] “Going forward, I hope to see a fundamental shift in how we view patient engagement in healthcare. I envision healthcare systems where patients and families are empowered as true partners. In safety, this means implementing systematic approaches to encourage patients to speak up about concerns, ask questions about their care, and actively participate in safety protocols.

Ultimately, our goal is to create a culture where patient’s voices are not just heard, but are actively sought out and valued as essential components of safe care.”

[Bechtel] Thank you so much to van Pelt for contributing to the show today. We are looking forward to the future of anesthesia patient safety that includes active patient participation and engagement.

If you have any questions or comments from today’s show, please email us at [email protected]. Please keep in mind that the information in this show is provided for informational purposes only and does not constitute medical or legal advice. We hope that you will visit APSF.org for detailed information and check out the show notes for links to all the topics we discussed today.

The 2025 APSF Stoelting Conference is happening right now! The focus for this years conference is “Transforming Maternal Care: Innovations and Collaborations to Reduce Morbidity and Mortality.” Conference objectives include innovative strategies to reduce severe maternal morbidity, actions that anaesthesia clinicians can take to advance birth equity, the role of anesthesia professionals to reduce preventable causes of maternal mortality, and identify opportunities for collaboration across role groups to overcome current maternal care challenges. This is a high-yield conference for anyone interested in keep patients safe during maternal anesthesia care. We will be featuring highlights from the conference on upcoming podcast episodes and videos of the conference talks on you tube, so stay tuned.

Until next time, stay vigilant so that no one shall be harmed by anesthesia care.

© 2025, The Anesthesia Patient Safety Foundation