A collaborative pilot study to monitor and optimise access to urgent surgery during the period of reduced resources in Genoa, Italy caused by the COVID-19 pandemic, using a bespoke referral process and the SWALIS 2020 model to prioritise surgery by clinical urgency and waiting time

Monitoring the introduction of a model to audit, prioritise and optimise access to cancer and urgent surgery to all patients in the metropolitan area of Genoa during and after the COVID-19 pandemic. An inter-hospital collaborative feasibility & pilot study of a dedicated referral pathway adopting the SWALIS 2020 model to prioritise surgery by implicit clinical urgency and waited-against-maximum-time.

Status

Active, not recruiting

Phases

Unknown

Study type

Interventional

Source

ISRCTN

Registry ID

ISRCTN11384058

Enrollment

300

Registered

2020-05-26

Start date

2020-04-01

Completion date

Unknown

Last updated

2023-06-26

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

The severe imbalance and variable demand/supply for elective surgery during the COVID-19 pandemic, determined by postponements, backlog and "hidden" waiting lists Not Applicable

Interventions

A bespoke collaborative multicentre patient pathway based on: - inter-hospital hub & spoke referral and triage - waiting list management by the SWALIS 2020 model to prioritise and audit access to elec

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: Any urgent surgery patient (Italian Category A-30 Days) referred to any Department of Surgery in the metropolitan area of Genoa during the spring 2020 COVID-19 peak

Exclusion criteria

Exclusion criteria: 1. Emergency surgery patients 2. Routine surgery patients

Design outcomes

Primary

Measure	Time frame
Measured weekly, i.e. every Tuesday following the just-finished week: feasibility (weeks 1 and 2), pilot (weeks 3, 4, 5, 6): 1. Clinical complications and adverse events reportedly caused by the pathway (safety), measured by recording and numbering single reports by surgeons responsible for patient care on identified proforma at weekly MDT meetings 2. According to the SWALIS model, the waiting list is measured weekly through purposely designed performance indexes, including cross-sectional (for patients currently on the list at an index day) and retrospective views (for patients who received treatment during a given period T): 2.1. Priority (as average and SD) on the list (new for SWALIS 2020) (for each and all urgency categories) 2.2. Waiting time in days (as median and range) (for each and all urgency categories) 2.3. Waiting list length (as average and SD) (for each and all urgency categories)	—

Measure

Time frame

Measured weekly, i.e. every Tuesday following the just-finished week: feasibility (weeks 1 and 2), pilot (weeks 3, 4, 5, 6): 1. Clinical complications and adverse events reportedly caused by the pathway (safety), measured by recording and numbering single reports by surgeons responsible for patient care on identified proforma at weekly MDT meetings 2. According to the SWALIS model, the waiting list is measured weekly through purposely designed performance indexes, including cross-sectional (for patients currently on the list at an index day) and retrospective views (for patients who received treatment during a given period T): 2.1. Priority (as average and SD) on the list (new for SWALIS 2020) (for each and all urgency categories) 2.2. Waiting time in days (as median and range) (for each and all urgency categories) 2.3. Waiting list length (as average and SD) (for each and all urgency categories)

—

Secondary

Measure	Time frame
Measured weekly, i.e. every Tuesday following the just-finished week: feasibility (weeks 1 and 2), pilot (weeks 3, 4, 5, 6): 1. Appropriate Performance Index (API) (for each and all urgency categories): 1.1. Retrospective: percentage of patients receiving treatment within their respective MTBT in a given period T 1.2. Cross-sectional: percentage of patients currently on the list at an index day having waiting time less than their respective MTBT 2. Deviation events (total and percentage). These include updates in urgency during wait, number of postponements (prior to the day of admission) or cancellations (on the day)	—

Measure

Time frame

Measured weekly, i.e. every Tuesday following the just-finished week: feasibility (weeks 1 and 2), pilot (weeks 3, 4, 5, 6): 1. Appropriate Performance Index (API) (for each and all urgency categories): 1.1. Retrospective: percentage of patients receiving treatment within their respective MTBT in a given period T 1.2. Cross-sectional: percentage of patients currently on the list at an index day having waiting time less than their respective MTBT 2. Deviation events (total and percentage). These include updates in urgency during wait, number of postponements (prior to the day of admission) or cancellations (on the day)

—

Countries

Italy

Outcome results

None listed

Source: ISRCTN (via WHO ICTRP) · Data processed: Feb 16, 2026