Ferschl Marla B, Tung Avery, Sweitzer BobbieJean, Huo Dezheng, Glick David B
University of Chicago Hospitals, IL 60637, USA.
Anesthesiology. 2005 Oct;103(4):855-9. doi: 10.1097/00000542-200510000-00025.
Anesthesiologist-directed preoperative medicine clinics are used to prepare patients for the administration of anesthesia and surgery. Studies have shown that such a clinic reduces preoperative testing and consults, but few studies have examined the impact of the clinic on the day of surgery. The authors tested whether a visit to an anesthesia preoperative medicine clinic (APMC) would reduce day-of-surgery case cancellations and/or case delays.
The authors conducted a retrospective chart review of all surgical cases during a 6-month period at the University of Chicago Hospitals. Case cancellations and rates of first-start case delay over the 6-month period were cross-referenced with a database of APMC attendees in both the general operating rooms and the same-day surgery suite. The impact of a clinic visit on case cancellation and delay in both sites were analyzed separately.
A total of 6,524 eligible cases were included. In the same-day surgery suite, 98 of 1,164 (8.4%) APMC-evaluated patients were cancelled, as compared with 366 of 2,252 (16.2%) in the non-APMC group (P < 0.001). In the general operating rooms, 87 of 1,631 (5.3%) APMC-evaluated patients were cancelled, as compared with 192 of 1,477 (13.0%) patients without a clinic visit (P < 0.001). For both operating areas, APMC patients had a significantly earlier room entry time than patients not evaluated in the APMC.
An evaluation in the APMC can significantly impact case cancellations and delays on the day of surgery.
由麻醉医生主导的术前医学诊所用于让患者为麻醉和手术做好准备。研究表明,这样的诊所可减少术前检查和会诊,但很少有研究考察该诊所在手术当天的影响。作者测试了前往麻醉术前医学诊所(APMC)就诊是否会减少手术当天的病例取消和/或病例延误。
作者对芝加哥大学医院6个月期间的所有外科病例进行了回顾性病历审查。将6个月期间的病例取消情况和首次开始手术延迟率与普通手术室和当日手术套房中APMC就诊者的数据库进行交叉对照。分别分析了在两个地点就诊于诊所对病例取消和延迟的影响。
共纳入6524例符合条件的病例。在当日手术套房中,1164例接受APMC评估的患者中有98例(8.4%)被取消手术,而非APMC组的2252例中有366例(16.2%)被取消手术(P<0.001)。在普通手术室中,1631例接受APMC评估的患者中有87例(5.3%)被取消手术,而未就诊于诊所的1477例患者中有192例(13.0%)被取消手术(P<0.001)。对于两个手术区域,APMC患者的入室时间均显著早于未在APMC接受评估的患者。
在APMC进行评估可显著影响手术当天的病例取消和延误情况。