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ECONOMICS, EDUCATION, AND POLICY

Preanesthesia Clinics, Information Management, and Operating Room Delays: Results of a Survey of Practicing Anesthesiologists

Natalie F. Holt, MD, MPH^*, David G. Silverman, MD^*, Ravindra Prasad, MD, James Dziura, PhD, MPH, and Keith J. Ruskin, MD^*

From the Departments of *Anesthesiology and Neurosurgery, Yale University School of Medicine; Department of Biostatistics, General Clinical Research Center, Yale University School of Medicine, New Haven, Connecticut; Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; and ||ASA Committee on Electronic Media and Information Technology, American Society of Anesthesiologists, Park Ridge, Illinois.

Address correspondence and reprint requests to Natalie F. Holt, MD, MPH, Department of Anesthesiology, Yale University School of Medicine, 333 Cedar St., TMP 3, New Haven, CT. Address e-mail to natalie.holt{at}post.harvard.edu.

Abstract

BACKGROUND: One purpose of preanesthesia evaluation clinics (PECs) is to decrease the incidence of day-of-surgery delays and cancellations by ensuring that patients are medically ready for surgery. In several single-center studies, PECs have been shown to have a positive impact. However, limited information is available regarding their overall use and perceived effectiveness.

METHODS: A survey was distributed to attendees of the 2005 Annual Meeting of the American Society of Anesthesiologists. The survey addressed the national prevalence of PECs and the most common methods for referral to them. Respondents were also asked to address the impact of PEC visits on perceived prevalence of day-of-surgery delays caused by missing patient information.

RESULTS: One thousand eight hundred fifty-seven surveys were returned. Sixty- nine percent of respondents worked at institutions with a PEC. Fifty-seven percent of respondents indicated that delays occur in at least 1 in 10 patients not seen for preanesthesia evaluation prior to the day of surgery. For patients who had a PEC visit prior to surgery, the same frequency of delays was reported by 23% of respondents.

CONCLUSIONS: Day-of-surgery delays caused by missing information remain relatively common despite preanesthesia evaluation. Possible causes for these delays include failures of information transfer, lack of consensus on criteria for surgical readiness, or other institutional factors.

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999