Evidence map›Paper›PMID 36336577›Full record

ArticleThe British journal of surgery2022

Managing surgical demand when needs outstrip resource: qualitative investigation of colorectal cancer surgery provision in the first wave of the COVID-19 pandemic.

Carmel Conefrey, Cynthia Ochieng, Christin Hoffman, Daisy Elliott, Kerry Avery, Joanne Bennett, Natalie Blencowe, Sarah Duff, James Kinross, Angus McNair and 8 more

Erratum issuedOpen access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The British journal of surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 45% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors at 8 institutions in 1 country.

Carmel ConefreyPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Cynthia OchiengNIHR Bristol Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK.
Christin HoffmanNIHR Bristol Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK.ORCID 0000-0002-6293-3813
Daisy ElliottNIHR Bristol Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK.
Kerry AveryNIHR Bristol Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK.
Joanne BennettDepartment of General Surgery, Gloucestershire Royal Hospitals NHS, Gloucester, UK.
Natalie BlencoweNIHR Bristol Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK.
Sarah DuffDepartment of Surgery, Manchester University NHS Foundation Trust, Manchester, UK.ORCID 0000-0001-6760-6451
James KinrossImperial College Healthcare NHS Trust, London, UK.ORCID 0000-0002-0427-7643
Angus McNairNIHR Bristol Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK.ORCID 0000-0002-2601-9258
David MessengerDepartment of Coloproctology, University Hospitals Bristol and Weston NHS Foundation Trust, UK.
Anne PullybankDepartment of Surgery, North Bristol NHS Trust, Bristol, UK.
Baljit SinghDepartment of Colorectal Surgery, University Hospitals of Leicester NHS Trust, Leicester, UK.
Anni KingNIHR Bristol Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK.
Sarah E SquireAssociation of Coloproctology of Great Britain and Ireland Patient Liaison Group, Oxford, UK.
Jane BlazebyNIHR Bristol Biomedical Research Centre at University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK.ORCID 0000-0002-3354-3330
Barry MainBristol Dental School, University of Bristol, Bristol, UK.
Leila RooshenasPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
University Hospitals Bristol NHS Foundation Trust · GBNorth Bristol NHS Trust · GBUniversity of Bristol · GBGloucestershire Royal Hospital · GBImperial College Healthcare NHS Trust · GBManchester University NHS Foundation Trust · GBUniversity Hospitals of Leicester NHS Trust · GBUniversity Of Bristol Dental Hospital · GB

Funding

Bristol & Weston Hospitals CharityBristol Biomedical Research CentreMedical Research Council MR/S001751/1National Institute for Health ResearchUniversity Hospitals Bristol and Weston NHS Foundation Trust
6 · The paper itself

Abstract

backgroundAt the onset of the COVID-19 pandemic, elective surgical provision was severely affected by the need for hospital reorganization to care for critically ill patients. In response, National Health Service (NHS) England issued national guidance proposing acceptable time intervals for postponing different types of surgical procedure. This study reports healthcare professionals' private accounts of the strategies adopted to manage the imbalance of demand and resource, using colorectal cancer surgery as a case study.

methodsTwenty-seven semistructured interviews were conducted with healthcare professionals between June and November 2020. A key informant sampling approach was used, followed by snowballing to achieve maximum regional variation across the UK. Data were analysed thematically using the constant comparison approach.

resultsIn the context of considerable resource constraint, surgical teams overcame challenges to continue elective cancer provision. They achieved this by pursuing a combination of strategies: relocating surgical services; prioritizing patients within and across surgical specialties; adapting patient treatment plans; and introducing changes to surgical team working practices. Despite national guidance, prioritization decisions were framed as complex, and the most challenging of the strategies to implement, both practically and emotionally.

conclusionThere is a need to better support surgeons tasked with prioritizing patients when capacity exceeds demand.

Indexed as

Colorectal NeoplasmsCOVID-19Elective Surgical ProceduresHumansPandemicsState Medicine

Identifiers

PMID36336577
PMCPMC10364543
OpenAlexW4308299695

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.