Asymmetry in patient-related information disrupts pre-anesthetic patient briefing

Abstract

BackgroundIf one party has more or better information than the other, an information asymmetry can be assumed. The aim of the study was to identify the origin of incomplete patient-related preoperative information, which led to disruptions and losses of time during pre-anaesthetic patient briefing. We hypothesized that lower employees’ educational level increases the amount of disruptive factors.MethodsA prospective observational study design was used. Patient selection was depending on the current patient flow in the area of the clinic for pre-anesthetic patient briefing. Data were collected over a period of 8 weeks. A stopwatch was used to record the time of disruptive factors. Various causes of time losses were grouped to facilitate statistical evaluation, which was performed by using the U-test of Mann and Whitney, Chi-square test or the Welch-t-test, as required.ResultsOut of 221 patients, 130 patient briefings (58.8%) had been disrupted. Residents were affected more often than consultants (66% vs. 47%, p = 0.008). Duration of disruptions was independent of the level of training and lasted about 2,5 minutes and 10% of the total time of patient briefing. Most time-consuming disruptive factors were missing study results, incomplete case histories, and limited patient compliance.ConclusionsDisruptions during pre-anesthetic patient briefings that were caused by patient-related information asymmetry are common and account for a significant loss of time. The resultant costs justify investments in appropriate personnel allocation.

Patientenakzeptanz einer Telefon-basierten Anästhesieaufklärung

“…Dabei bleibt zu berücksichtigen, dass die ökonomisch begründete Nutzung von Anästhesieambulanzen in erster Linie hilft, Kosten zu senken [18]. Der zumeist dadurch begründete Arztwechsel vom "prämedizierenden" zum narkotisierenden Anästhesiologen kann dagegen einen sicherheitsrelevanten Informationsverlust generieren [19]. Wenn in gleich Weise auch die Vertrauensbildung des Patienten durch diesen Arztwechsel erschwert wird, stellt sich die Frage, ob durch eine Telefon-basierte Anästhesieaufklärung dem Patientenwunsch nach Personalunion in geeigneten Fällen wieder besser entsprochen werden könnte.…”