Abstract
Many surgical procedures are delayed or cancelled due to inadequate preoperative assessment and preparation. We describe the case referral pattern and efficiency of our preadmission anaesthesia consultation clinic, which was designed to minimize this problem. Data were collected prospectively on the first 400 patients referred to the clinic. Sixty per cent of referrals were related to the cardiovascular system, in particular coronary artery disease (27%). Eighty-one per cent of referrals were considered appropriate. With ideal functioning of the clinic, delays and cancellations could potentially be reduced to 0.75% and 1.5% of cases respectively. The clinic was well accepted and appreciated by patients. We conclude that this represents a potential important reduction in hospital costs and improvement in operating room efficiency.
Résumé
Plusieurs interventions chirurgicales sont retardées ou annulées à cause d’une évaluation et d’une préparation préopératoires inadéquates. Nous analysons ici les modalités de la préconsultation et l’efficacité de notre clinique de préadmission laquelle a été conçue pour minimiser les inconvénients des problèmes déjà énoncés. Les données ont été amassées de façon prospective pour les 400 premiers patients référés à la clinique. Soixante pour cent des consultations étaient en rapport avec la système cardiovasculaire et plus particulièrement la maladie coronaire (27%). Quatrevingt pour cent furent jugées appropriées. Avec unfonctionnement idéal, les délais et annulations pourraient être réduits à 0,75% et 1.5% respectivement. La clinique est bien acceptée et même appréciée par les patients. Nous concluons que ce mode de fonctionnement représente une réduction importante des coûts hospitaliers et une amélioration appréciable du degré d’efficacité pour les salles d’opération.
Article PDF
Similar content being viewed by others
References
Lee JA. The anaesthetic outpatient clinic. Anaesthesia 1949; 4: 169–74.
Burk N, Mazzei W. The need for an anesthesia preoperative evaluation centre. Anesth Analg 1990; 70: S44.
Hew-Wing P, Rolbin SH, Hew E. Outpatient anaesthetic consultations for pregnant patients (Letter). Can J Anaesth 1989; 36: 102.
Murchison D. Preoperative outpatient consultation in private anaesthetic practice. NZ Med J 1991; 104: 429–31.
Frost EAM. Outpatient evaluation: a new role for the anesthesiologist. Anesth Analg 1976; 55: 307–10.
Henderson JA. Ambulatory surgery: past, present, and future.In: Wetchler BV (Ed.). Anesthesia for Ambulatory Surgery, 2nd ed., Philadelphia: J.B. Lippincott, 1991: 23.
Meridy HW. Criteria for selection of ambulatory surgical patients and guidelines for anesthetic management: a retrospective study of 1553 cases. Anesth Analg 1982; 61: 921–6.
Orkin FK, Gold B. Selection.In: Wetchler BV (Ed.). Anesthesia for Ambulatory Surgery, 2nd ed., Philadelphia: J.B. Lippincott, 1991: 90–101.
Ross DJ, Watson SJ. Cancellations in elective joint surgery — are they avoidable? Health Bulletin 1988; 46: 106–9.
Kleinfeldt AS. Preoperative phone calls reducing cancellation in paediatric day surgery. Journal of the Association of Operating Room Nurses 1990; 51: 1559–63.
MacArthur AJ, MacArthur C, Bevan JC. Preoperative assessment clinic reduces day surgery cancellations. Anesthesiology 1991; 75: A1109.
Pasternak LR. Anesthetic considerations in otolaryngological and ophthalmological outpatient surgery. Int Anesthesiol Clin 1990; 28: 89–100.
Eagle C, Davies JM. Preoperative consultation and assessment of anesthetic risk. Annals Royal College of Physicians and Surgeons of Canada 1989; 22: 336–8.
Cohen NH, Tschann JM, Adamson TE. Assessment of patient satisfaction with anaesthesia services. Anesth Analg 1988; 67: S34.
Leigh JM, Walker J, Janaganathan P. Effect of preoperative anaesthetic visit on anxiety. BMJ 1977; 2: 987–9.
Anderion JM. The value of joint anaesthetic and surgical preoperative assessment. Br J Anaesth 1972; 44: 183–90.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Conway, J.B., Goldberg, J. & Chung, F. Preadmission anaesthesia consultation clinic. Can J Anaesth 39, 1051–1057 (1992). https://doi.org/10.1007/BF03008374
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF03008374