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2015 ; 4
(ä): 12
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Day of surgery cancellation rate after preoperative telephone nurse screening or
comprehensive optimization visit
#MMPMID26664719
Olson RP
; Dhakal IB
Perioper Med (Lond)
2015[]; 4
(ä): 12
PMID26664719
show ga
BACKGROUND: Structured preoperative assessment has been reported to improve
operating room efficiency as measured by metrics such as day of surgery
cancellations (DOSCs). However, not all patients require comprehensive
assessment; routine full assessments can result in unnecessary duplication of
tests and investigations. Selective nurse screening under the supervision of
anesthesiology may provide adequate information gathering in lower risk patients.
This study is undertaken to assess if DOSC rates vary with different assessment
processes. METHODS: At a single academic tertiary care hospital, from Jan 2 to
May 31, 2013, the consecutive patients undergoing comprehensive preoperative
assessment (CPA) and nurse screening (NS), as well as the patients not assessed
by the anesthesiology-supervised preoperative process, were followed for the
occurrence and reason for DOSC. The operating room schedule of all elective
surgery patients was analyzed to allow calculation of rates of DOSCs. Reasons for
cancellations were documented as one of ten structured reasons by preoperative
holding area clerical staff. RESULTS: Overall, there were 14,893 elective surgery
patients in this time period, with 183 DOSCs, giving a rate of 1.23 % (95 % CI
1.06, 1.42). Patients who received CPA numbered 5980; 29 of them had a DOSC,
giving a rate of 0.48 % (95 % CI 0.33-0.70) (P?0.0001 vs. no assessment).
Patients receiving NS numbered 1840; 11 of them had a DOSC, giving a rate of
0.60 % (95 % CI 0.30-1.10) (P?0.0001 vs. no assessment). The most common reason
for cancellation was new medical condition. CONCLUSIONS: A very low DOSC rate can
be achieved with a comprehensive preoperative process where some patients are
selectively telephone screened by nurses, with complete assessment deferred to
the anesthesiologist on the day of surgery.