Surgery
accessible and supportive. The questionnaires have been translated into thirteen different languages. In addition, resources (such as an animated video on surgical wound recovery at home) are available in accessible formats. Family and cultural aspects are also considered, such as existing support systems. For example, the patient can nominate their next of kin to receive requests. “Using traditional, retrospective telephone or postal questionnaires at 30 days is labour- intensive and provided no benefit for patients if they developed SSI in the community. “Using a proactive approach, using Isla’s
technology, brings the specialist knowledge of post-operative wound care and infection prevention directly to the patient’s home,” comments Jamie Croker, Team Leader for the Central Digital Wound Hub.
The Central Digital Wound Hub The Central Digital Wound Hub (CDWH) serves a crucial role in post-discharge surgical wound monitoring, specifically targeting patients who have undergone surgeries such as cardiac, thoracic, vascular, general surgery, breast and Caesarean sections within GSTT. Since beginning, over 19,000 patients and
carers have benefitted from the remote wound monitoring programme. Patient submissions of surgical wound photos and wound healing questionnaires are reviewed by trained clinical staff, including Registered Nurses and Assistant Practitioners, who assess the images and data to monitor healing progress and address any signs of infection according to our GSTT protocols and Standard Operating Procedures. Importantly, the team will call the patient or carer if further information is needed. Although
an automated tag for SSI is applied in Isla based on the answers provided by the patient, the GSTT team will use clinical judgement and adjudication processes to add or remove a tag as necessary. “The dedication and commitment to patient
care have truly made a remarkable impact. The transformation to a digital care model has been exceptional, streamlining patient monitoring and enhancing outcomes. “The results speak for themselves — patient
care has significantly improved, and I am highly impressed with the level of patient engagement. The team’s efforts in advancing digital healthcare have set a new standard for excellence,” comments Mr Nizar Asadi, MD, Consultant Thoracic Surgeon. Mr Abrie Botha, Consultant Upper GI, adds:
“The service has given us the opportunity to keep an eye on high-risk wounds, both infected and uninfected. It has also helped us with scheduling post-operative out-patient follow-up appointments at more appropriate times. It improved the patient experience by giving them more frequent contacts with the hospital during their post-operative recovery, and allowed district nurses to receive hospital feedback on their home wound care.” Our GSTT post-discharge monitoring using patient smartphones relies on five elements or pillars (see panel below). The service operates seven days a week, offering patients timely advice, reassurance, and access to necessary interventions without requiring in-person visits. If concerns are raised, the CDWH team can
Patient reported surgical site infection surveillance
The five pillars of GSTT post-discharge surveillance, using Isla, includes a ‘SWIFT’* approach: Smart, Well-connected, Inclusive, Flexible, and Therapeutics. These are interdependent and reinforce one another to create a cohesive and effective surveillance system. The pillars include:
1. Smart devices for proactive, patient- reported wound monitoring drives the system by facilitating early detection of complications, enabling timely escalation and intervention. This relies on the well- connected structure to ensure that data from proactive monitoring is shared seamlessly across care pathways, allowing for an informed response.
2. Well-connected pathways enable healthcare teams to act on the data collected through proactive and inclusive surveillance. Without integration into patient records and care workflows, the benefits of early detection and inclusive monitoring would be limited. Integrated care also supports clinical
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judgment by providing clinicians with the necessary data to make informed decisions.
3. Inclusive surveillance ensures that all patient groups have equal access to monitoring and timely care. Inclusivity strengthens the proactive element by broadening the patient base, ensuring that data and insights are representative of diverse populations, and reducing disparities in care delivery.
4. Flexibility to use clinical judgment is essential to interpret data gathered through proactive and inclusive surveillance. Even with automated or patient-reported data, clinical oversight ensures accuracy, reduces false positives, and allows for tailored interventions based on the individual patient’s context. Clinical
judgment also informs therapeutic (antimicrobial) monitoring by assessing whether an antimicrobial intervention is necessary.
5. Therapeutic (antimicrobial) monitoring closes the loop by tracking treatment responses and outcomes. Data can feed back into the proactive and integrated systems, refining surveillance protocols and improving future decision- making. It also ensures that flexible clinical judgment is supported by real-world evidence, reducing the risk of overtreatment or resistance.
*‘SWIFT’ surveillance © 2025, M Rochon and G Bond-Smith. All rights reserved.
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