While data on the benefits of pre-habilitation (a pre-surgery health conditioning program) is extensive and growing, and has contributed to recommendations and guidelines for prehab integration into usual patient care, few studies have examined how to implement a prehab program in a large surgical program - and if it could be successful.
Daniel Santa Mina, an associate professor at the University of Toronto Faculty of Kinesiology and Physical Education (KPE) specializing in exercise oncology, and Ian Randall, staff anesthesiologist and intensive care unit physician at the University Health Network (UHN), set out to do exactly that.
They co-authored a study recently published in the Canadian Journal of Anesthesiology, in which they detail all the groundwork that went into the development and successful implementation of the UHN Surgical Prehab Program, of which they are both an integral part.
“Our data contributes novel perspectives to the study, design and implementation of prehab programs, including identifying stakeholder priorities and factors that affect compliance and adherence to the program,” says Santa Mina. “Importantly, it shows that prehab programming can be feasibly integrated into a large surgical program at a tertiary health care centre, with numerous patient outcomes improved during the course of the preoperative period.”
The study, which involved numerous other clinicians, researchers and U of T graduate students, marks a significant milestone for the prehab program and highlights the innovative work being done under the leadership of Santa Mina and Randall to optimize care and improve outcomes for UHN’s most vulnerable surgical patients.
Some of these highlights include over 1,400 referrals and more than 1,000 participants in the prehab program since 2021, with 80% of participants coming from oncology, cardiac and solid organ transplant programs.
“Testimonials from patients, family members and referring surgeons all underscore the program's positive impact on physical strength, functional status and overall preparedness for surgery,” says Santa Mina. “This is further supported by our data, which shows significant improvement in patient functional capacity prior to surgery - a key predictor of surgical outcomes.”
Currently one of the largest programs of its kind in the world, Santa Mina hopes UHN’s Surgical Prehab Program will continue to grow, while also providing a blueprint for similar programs to be implemented in comparable health settings.
Santa Mina will be joining Associate Professor Linda Trinh, Assistant Professor Amy Kirkham and Professor Catherine Sabiston, all of KPE, on November 18 at 6 pm for a free, interactive online symposium focusing on enhancing cancer care through diet and exercise.