A prospective observational study of the impact of an electronic questionnaire (ePAQ-PO) on the duration of nurse-led pre-operative assessment and patient satisfaction

Abstract

ObjectiveStandard pre-operative assessment at our institution involves a comprehensive history and examination by a nurse practitioner. An electronic pre-operative assessment questionnaire, ePAQ-PO® (ePAQ, Sheffield, UK) has previously been developed and validated. This study aimed to determine the impact of ePAQ-PO on nurse consultation times and patient satisfaction in low-risk patients.MethodsThe duration of pre-operative assessment consultation was recorded for American Society of Anesthesiology physical classification 1 and 2 patients undergoing pre-operative assessment by an electronic questionnaire (ePAQ-PO group) and standard face-to-face assessment by a nurse practitioner (standard group). Patients were also asked to complete an eight-item satisfaction questionnaire. Eighty-six patients were included (43 in each group).ResultsAfter adjusting for the duration of physical examination, median (IQR [min-max]) consultation time was longer in the standard compared to the ePAQ-PO group (25 (18–33 [10–49]) min vs. 12 (8–17 [4–45]) min, respectively; p <0.001). Response rate for the satisfaction questionnaire was 93%. There was no significant difference in patient satisfaction scores (38/39 in standard group vs. 39/41 in ePAQ-PO group were fully satisfied with their pre-operative assessment; p = 0.494).ConclusionPre-operative assessment using ePAQ-PO is associated with a significant reduction of over 50% in the duration of the assessment without impacting on patient satisfaction.

Effect of PreAnaesThesia Computerized Health (PATCH) Assessment on Duration of Nurse—Patient Consultation and Patient Experience: A Pilot Trial

“…Patient satisfaction was also comparable between the two modes of screening. A similar conclusion was reached in a previous study that considered the assessment of patient satisfaction as a quality metric [ 19 ].…”

“…The design of our study also differed from those of other studies, in that it was a randomized feasibility trial that employed a standard electronic method for measuring consultation time in real time for both arms. This is in contrast to one study, in which the duration of assessment of standard care patients was not measured in real time, but derived using an equation that adjusted for age and American Society of Anesthesiologists (ASA) status [ 19 ]. Hence, findings could have been biased by having mainly ASA classes 1–2 patients in the digital arm, while patients of ASA classes 1–4 received standard care.…”

“…It is somewhat surprising that the present study did not find any significant difference in nurse–patient consultation times between computerized and nurse-led preanaesthesia health assessment. Previous studies that evaluated the effects of tablet- and web-based applications on the duration of PHA had reported a significant reduction of 5 min ( p < 0.001) and 13 min ( p < 0.001), respectively, compared to face-to-face assessments [ 19 , 23 ]. We postulate a few reasons for our observations.…”

“…The comparable duration of nurse–patient consultation for both groups supports our hypothesis of equivalence, whereby the response to two treatments is “not too different” or differs only by a clinically unimportant amount [ 26 , 27 ]. One study reported that the time saved could be used efficiently to assess more low-risk patients or focus on higher-risk patients [ 19 ].…”

“…We assessed patient satisfaction with PHA as a quality metric, similar to a previous study [ 19 ]. After the nurse–patient consultation, all patients had to complete a survey, consisting of four items measuring general satisfaction, graded on a five-point semantic scale, adopted from a previous questionnaire [ 22 ].…”