A reply


We thank Drs Tompsett and van Hasselt for their comments on our article [1]. It is interesting that they found the question-set to be ‘blunt in style and limiting’, as the Heidelberg questions have been rigorously validated scientifically. Their survey has had opinion and adaptation from within their institution only, but has not been formally validated.

Despite this, we are in full support of such adaptation, as it allows anaesthetists to tailor questions appropriately for the local patient population. However, it would be very difficult to recommend an institution-specific questionnaire for general use as an ‘ideal’ question-set, which is why we used a shortened version of the Heidelberg questionnaire as a starting point in our work.

Patient feedback to anaesthetists remains an under-examined area. Validated, generic patient questionnaires are simply irrelevant to much of anaesthetic practice, but rejection of these and use of anaesthesia-specific questionnaires could introduce selection bias towards positive responses. For anaesthesia-specific questionnaires to be of benefit they must be easily reproducible and continuous, use a stable dataset and involve numerous dedicated personnel in the time-consuming collection of complex data. Many institutions do not have the finances or manpower to do this.

We found strikingly similar results to Tompsett and van Hasselt, having performed four cycles of our questionnaire. Other reported problem areas in our hospital were postoperative nausea, thirst and postoperative shivering. Such results have allowed us to target these specific problem areas with active measures (provision of warmed blankets in the recovery room, a new postoperative nausea and vomiting prevention protocol and oral fluid prescription), in order to improve the patient journey.

It is so important that we get it right for our patients, as the precious little time we spend with them has a massive impact on their overall experience. We would be very interested to see Tompsett and van Hasselt’s questionnaire. We also feel that the benefit of UK-wide survey results could only improve things even further and pave the way for more specific, targeted patient feedback for revalidation purposes.