Anaesthesia preadmission assessment: a new approach through use of a screening questionnaire

Purpose: The preadmission assessment of patients one to two weeks preoperatively has become the standard across North America, We have devised a new approach that utilises a preoperative screening questionnaire and this study attempted to determine the effectiveness of this technique, Methods: Over six weeks, the attending anaesthetist for each patient undergoing non-cardiac surgery processed through the preadmission clinic (PAC) completed a study survey, This survey questioned if the assessment was appropriate with reasons, the consequences of no assessment, and if time was saved/lost on the day of surgery, Results: Three hundred and seventy patients were processed (243 same-day(SD), I I I outpatient(O/P), and 16 inpatients (I/P)). Of these, 224 were assessed in the PAC (101 by medicine, 84 by anaesthesia;nd 39 by both): 42% (94) based on the questionnaire, 12% (26) due to consultation, and 46% (104) due to positive questionnaires and consultation, The physician assessments were appropriate 184/219 (84%) times, inappropriate in 35 (16%), while there was no answer for five. Assessments were inappropriate because 25/35 (71%) were unnecessary, while in nine (26%) the patient was not optimised. Of the patients not assessed in the PAC only 9/145 (6%) should have been assessed, Conclusion: The use of our screening tool in combination with direct referrals appropriately determines assessment needs of patients and allows for more efficient used medical personnel in the PAC.