Development of a Preoperative Patient Clearance and Consultation Screening Questionnaire

Abstract

The optimal timing of the preanesthesia evaluation varies with the patient's comorbidities. As anesthesiologists assume a broader role in perioperative care, there may be opportunities to provide additional patient management beyond historical routine anesthesia services. This study was thus undertaken to survey our institutional perioperative clinicians regarding their perceptions of patient medical conditions that (a) need additional time for preoperative clearance by anesthesiology before actually scheduling the date of surgery and (b) warrant additional preoperative evaluation and management services by an anesthesiologist. These data were used to create a pilot version of a Preoperative Patient Clearance and Consultation Screening Questionnaire.

A Swiss nationwide survey shows that dual guidance is the preferred approach for peripheral nerve blocks

“…Thorsten Steinfeldt (Germany), Urs Eichenberger (Switzerland) and Axel R. Sauter (Norway), developed a qualitative online survey to assess clinical approaches currently used by anesthesiologists in Switzerland as a preliminary, exploratory study as previously described by Vetter et al . 21 . Given the nature of a preliminary, exploratory qualitative survey, no formal psychometric reliability or validity tests were performed 21 .…”

“…21 . Given the nature of a preliminary, exploratory qualitative survey, no formal psychometric reliability or validity tests were performed 21 . For every response simple numerical counts were determined as described before 21 .…”

“…Given the nature of a preliminary, exploratory qualitative survey, no formal psychometric reliability or validity tests were performed 21 . For every response simple numerical counts were determined as described before 21 . The online survey with questions about nerve localization tools, safety, and technical approaches used for PNB was prepared in German, French, and Italian versions using the online platform SurveyMonkey (SurveyMonkey Inc., San Mateo, California, USA, www.surveymonkey.com).…”

“A Time of Opportunity”

“…A brief report from Vetter et al 6 describes that, by implementing a pilot program of a Preoperative Patient Clearance and Consultation Screening Questionnaire, they were able to provide greater clarity on the amount of time needed for preoperative clearance by the anesthesiology service before actually scheduling the date for surgery, as well as provide a better indication for additional preoperative evaluation and management services by an anesthesiologist. Implementation of the questionnaire resulted in a tentative 21-day advance surgery date and a priority preoperative assessment, consultation, and treatment clinic evaluation.…”

“…This allowed the anesthesiologist to determine whether a patient's clinical condition was optimized to permit scheduling of a surgical procedure and, if not, request assistance in managing the preoperative care of comorbidities (eg, assessing and managing underlying clinical conditions, such as coronary artery disease, chronic obstructive pulmonary disease, asthma, and diabetes mellitus). 6 The articles cited above in this issue of Anesthesia & Analgesia emphasize how collaboration across the continuum of care within the specialty and other affiliated services within a hospital, adherence to established evidence-based guidelines, and preoperative optimization and planning all advance the triple aim and improve patient safety.…”