ABSTRACT
This chapter describes how surgical processes have been improved in Salisbury, England, using pathways in three areas of care: symptomatic breast disease, high-volume general surgical conditions and emergency general surgical admissions. When a general practitioner is faced with a patient who presents with a breast symptom, the doctor must initially decide if the patient requires assessment in secondary care and if so, with what degree of urgency. Patients benefit from being given a consistent assessment and information package, allowing them to anticipate more accurately the course of their admission. The encouragement of day surgery activity has positive implications for the efficiency of a surgical unit. Surgical nurse navigators act as a point of continuity in the care of emergency surgical admissions. Once a decision has been made to proceed with surgery, the nurse issues the patient with an in-depth information leaflet, which is explained fully to them. Patients should be involved throughout the development and monitoring of a pathway.
