Online versus non-standard face to face preoperative assessment: Cost effectiveness |
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| Authors: | Blanco Vargas D Faura Messa A Izquierdo Tugas E Santa-Olalla Bergua M Noguera Sopeña M M Mañoso Noriego M |
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| Affiliation: | 1. Division of Pediatric Surgery, Department of Surgery, Medical University of South Carolina, Charleston, SC, USA;2. Division of Pediatric Surgery, Department of Surgery, Baylor College of Medicine and Texas Children’s Hospital, Houston, TX, USA;1. Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taiwan;2. Department of Computer Science and Information Engineering, National Taiwan University, Taiwan;3. Department of Electrical Engineering, National Taiwan University, Taiwan;4. Department of Surgery, National Taiwan University Hospital, Taiwan;5. Department of Medical Education & Bioethics, Graduate Institute of Medical Education & Bioethics, College of Medicine, National Taiwan University, Taiwan;1. Anestesiología y Reanimación, Hospital Universitario de Canarias, España;2. Unidad de Reanimación Postoperatoria, Hospital Universitario de Canarias, España;1. Division of Vascular Surgery, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, ON, Canada;2. Department of Anesthesia and Pain Management, University Health Network, University of Toronto, Toronto, ON, Canada;3. Department of Interventional Radiology, University Health Network, University of Toronto, Toronto, ON, Canada;1. Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, CH-3010, Bern, Switzerland;2. Center for Advanced Heart Failure, Cardiopulmonary Support and Transplantation Program, Memorial Hermann Heart & Vascular Institute, Texas Medical Center, and University of Texas McGovern Medical School, 6400 Fannin St., Suite 2350, Houston 77030, TX, USA;3. Department of Neurosurgery, Kantonsspital Aarau, Tellstrasse 25, 5001, Aarau, Switzerland;4. Department of Neurosurgery, University of Pittsburgh School of Medicine, 200 Lothrop Street, Pittsburgh, PA, 15213, USA;5. Department of Colorectal Surgery, St. Marien-Krankenhaus, Marienstraße 6–8, 49377, Vechta, Germany;6. Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse, CH-3010, Bern, Switzerland;7. Department of Anesthesiology, University of California San Diego, 9300 Campus Point Dr, 92037, La Jolla, CA, USA;8. Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women''s Hospital, Harvard Medical School, 75 Francis Street, 02115, Boston, MA, USA |
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| Abstract: | ![]()
ObjectivesWe evaluate the efficiency of an online preoperative assessment service that allows early triage of patients that require further assessment in advance of the clinic and reduces the number of preoperative tests.MethodsWe developed a preoperative assessment process where the anesthesiologist collected on-line information without the physical attendance of the patient that included the patient's health history and all the preoperative tests performed in the primary and hospital care. Once confirmed this information by a telephone call, the anesthesiologist identified those patients that required further face to face assessment and limited the number of preoperative tests according to the complexity of the operative procedure and the anesthetic risk. In some procedures trained nursery collected on – line information and in certain cases consulted the anesthesiologist. We compared a cohort of preoperative patients before (2008) and after (2010) developing this online preoperative assessment process. We determined in both periods the number of face to face preoperative assessments and preoperative tests performed. Finally, we compared the cancellation rate in both periods.Results5112 elective surgical procedures in 2008 and 6867 elective surgical procedures in 2010 were assessed. In 2010, face to face preoperative assessments dropped to 21%, the number of laboratory tests 15%, the number of electrocardiograms 6% and the number of chest x-rays 1%. The cancellations rate didn’t differ between 2008 (2,3%) and 2010 (1.75%).ConclusionsThis preoperative process optimizes the resources reducing the number of face to face preoperative assessments and preoperative tests without increasing the cancellations rate. |
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