Effectiveness of pre-anaesthetic assessment clinic: a systematic review of randomised and non-randomised prospective controlled studies

Kristoffersen, Eirunn Wallevik; Opsal, Anne; Tveit, Tor Oddbjørn; Berg, Rigmor C.; Fossum, Mariann

doi:10.1136/bmjopen-2021-054206

Cited by 21 publications

(18 citation statements)

References 50 publications

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“…59 Perioperative optimization performed by anesthesiologists through the perioperative surgical home has helped decrease patient length of stay, improve quality, and lower the cost of care. 60 It allows an efficient approach to screen patients for surgery that better identifies and optimizes medically complex patients. 61 While clinical care pathways improve certain measurable disparities, they do not address individual patient and clinician factors that can drive disparities.…”

Section: Clinical Care Pathwaysmentioning

confidence: 99%

Closing the gap: Perioperative health care disparities and patient safety interventions

Rangrass,

Obiyo,

Bradley

et al. 2024

International Anesthesiology Clinics

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A main priority of today's health care system is addressing the contributions of systemic and structural factors to health care disparities. 1,2 Over several decades, research in health care disparities and health services has described how health care is organized, delivered, financed, and accessed and characterized how policies and interventions impact cost, quality, outcomes, and patient safety. Patient safety is founded on the principle that health care professionals are well intentioned but function within systems that can produce untoward effects for patients and populations. Patient safety, health, and health care disparities are inextricably linked. Therefore, exploring health care disparities in perioperative care, why they exist, and offering potential strategies to enhance equity is essential to improving patient safety. 3 Patient-centered care considers an individual's specific health needs and desired health outcomes and can serve as a path forward toward reducing disparate care. The way patients interact with clinicians and the health care system can significantly alter their perioperative trajectories. Anesthesiologists are uniquely involved in the entire spectrum of perioperative care, and patientcentered care remains a high priority in the management of pain and sequelae of anesthetic care.In this article, we will discuss evidence suggesting that racial and ethnic minorities receive differential anesthetic care relative to their white counterparts. Differential care is seen preoperatively during planning and medical optimization, intraoperatively in the choice of anesthetic technique, and postoperatively related to pain control and the management of unforeseen complications. We will then describe the individualclinician level (patient-centered) interventions and system-level (local, regional, and national) policies that can be implemented to reduce perioperative disparities.

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Section: Clinical Care Pathwaysmentioning

confidence: 99%

Closing the gap: Perioperative health care disparities and patient safety interventions

Rangrass,

Obiyo,

Bradley

et al. 2024

International Anesthesiology Clinics

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“…It is effective tool to obtain the patients current and past medical history, vital statistics to identify the multifactorial perioperative risks which requires plan of management before anesthesia and surgery [1]. Preanesthetic assessment reduces the cancellation of surgery, length of stay hence reduces the cost and enhances patient safety [2]. Inadequate preoperative evaluation and poor patient preparation significantly increases the odds of complications [3].…”

Section: Introductionmentioning

confidence: 99%

Clinical Audit on the Practice of Documentation at Pre-Anesthetic Evaluation in Teaching Institut

Karnalka¹,

Andhal²,

Khedeka³

2023

PIJR

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Introduction: The preanesthetic evaluation, documenting it and maintaining the record is the responsibility of anesthetist. Better documentation practices can improve the patient's outcome. It has the pivotal role in medicolegal aspects. However, the documentation is one of the challenges when it comes to quality of care. The objective of the study was to assess the practice of documentation at preanesthetic evaluation and completeness of Preanesthetic evaluation tools. Method: The descriptive study was conducted in tertiary care hospital. Modied global quality index (GQI) is used to prepare the Predefined twenty-two indicators.The data analysis is done using SPSS version-20.Result: A total of 300 pre-anesthetic evaluation tools (PAETs) were reviewed. There was different trend in terms of completion rate for elective and emergency cases. However, there was no PAETs found complete. Indicators with high completion rate (>90%) were signed a consent, past medical history (PMH), history of medication, allergy, surgical procedure, cardiovascular examination, airway examination and respiratory examination. Anesthetic plan, premedication, vital signs, a name, per-oral status and age were found with below average (<50%) completion rate. Conclusion and recommendations: Documentation during the preanesthetic visit observed below the standard. Which need to be standardized for uniformity. Use of electronic system with prefilled formats and training of personnel involved in the process is the way forwar

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“…3,4 It has been shown that pre-anaesthetic assessment may reduce patient anxiety regarding perioperative care, rate of surgery, cancellation or postponement, and length of hospital stay. 5 Moreover, the omission of pre-anaesthetic assessment is associated with, for example, a higher risk of unanticipated adverse perioperative events and a negative impact on patient outcomes. 5 Despite being very common and essential for many patients undergoing surgery, the literature provides no standard definition of pre-anaesthesia assessment.…”

Section: Introduction 1| Rationalementioning

confidence: 99%

“…5 Moreover, the omission of pre-anaesthetic assessment is associated with, for example, a higher risk of unanticipated adverse perioperative events and a negative impact on patient outcomes. 5 Despite being very common and essential for many patients undergoing surgery, the literature provides no standard definition of pre-anaesthesia assessment. 3 Consequently, little is known about the different pre-anaesthetic assessment approaches (who, where, and why the particular choice of approach) and which outcomes, including patient satisfaction and patient perceptions of the quality of health services, are assessed.…”

Section: Introduction 1| Rationalementioning

confidence: 99%

Pre‐anaesthetic assessment and related outcome measures in adults undergoing elective surgery—Scoping review protocol

Brix

Gamst‐Jensen

Nielsen

et al. 2023

Acta Anaesthesiol Scand

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Background Pre‐anaesthesia assessment is crucial to ensure the quality and safety of anaesthesia and surgery. However, despite being very common and essential for many patients undergoing elective surgery, little is known about the different pre‐anaesthesia assessment approaches. Hence, this article outlines a study protocol for a scoping review aiming to, systematically, map the literature on pre‐anaesthetic assessment approaches and outcomes, synthesise existing evidence, and identify knowledge gaps for future research. Methods We will conduct a scoping review of all study designs following the Preferred Reporting Items for Systematic and Meta‐Analyses (PRISMA) statement. Moreover, the five steps set forth by Arksey and O'Malley and refined by Levac will guide the review process. Studies with adults (≥18 years) scheduled for elective surgery are included. Data regarding trial characteristics, patients, clinicians performing the pre‐anaesthetic assessment, interventions and outcomes are included using a combination of Covidence and Excel. Quantitative data are summarised using descriptive statistics, and qualitative data are presented through a descriptive synthesis. Conclusion The outlined scoping review will provide a synthesis of the literature, which can support the development of new evidence‐based practices for safe perioperative management of adult patients undergoing elective surgery.

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Effectiveness of pre-anaesthetic assessment clinic: a systematic review of randomised and non-randomised prospective controlled studies

Cited by 21 publications

References 50 publications

Closing the gap: Perioperative health care disparities and patient safety interventions

Closing the gap: Perioperative health care disparities and patient safety interventions

Clinical Audit on the Practice of Documentation at Pre-Anesthetic Evaluation in Teaching Institut

Pre‐anaesthetic assessment and related outcome measures in adults undergoing elective surgery—Scoping review protocol

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