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ECONOMICS AND HEALTH SYSTEMS RESEARCH

Early Outpatient Preoperative Anesthesia Assessment: Does It Help to Reduce Operating Room Cancellations?

John B. Pollard, MD^*,, and Leslie Olson, RN

*Department of Anesthesia, Stanford University School of Medicine, Stanford; and Veterans Affairs Palo Alto Health Care System, Palo Alto, California

Address correspondence and reprint requests to John B. Pollard, MD, VAPAHCS, Anesthesiology Service 112A, 3801 Miranda Ave., Palo Alto, CA 94304. Address e-mail to John.Pollard{at}med.va.gov

Increased understanding of the high cost associated with operating room (OR) cancellations has led to efforts by healthcare providers to decrease case cancellations on the day of surgery. To investigate whether preoperative evaluations within 24 h of surgery were associated with more frequent OR cancellations than those completed 2–30 days before surgery, we prospectively studied OR cancellations for 3 mo. Of the 529 patients in the study, 166 were seen within 24 h of surgery (standard group), and the remaining 363 patients were seen 2–30 days before surgery (early group). There were 70 OR cancellations on the day of surgery, and the largest single group of cancellations was related to administrative problems. The standard group and the early group were similar in terms of gender, age, ASA physical status, and percentage of patients undergoing major surgery. The OR cancellation rates were also comparable between groups: 13.3% for the standard group and 13.2% for the early group. These data suggest that patients can be evaluated in an outpatient preoperative evaluation clinic in a timeframe that is convenient for the patient without adversely affecting the cancellation rate on the day of surgery.

Implications: The operating room cancellation rate for outpatients evaluated 2–30 days before surgery was compared with the cancellation rate for outpatients who received their anesthesia evaluation within 24 h of surgery. Because both groups had similar rates, outpatients may be seen at a convenient time without adversely affecting operating room cancellations.

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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