Blanco Vargas D, Faura Messa A, Izquierdo Tugas E, Santa-Olalla Bergua M, Noguera Sopeña M M, Mañoso Noriego M
Servicio de Anestesiología, Reanimación y Clínica del Dolor, Hospital de Viladecans, Viladecans, Barcelona, España.
Rev Esp Anestesiol Reanim. 2012 Aug-Sep;59(7):350-6. doi: 10.1016/j.redar.2012.05.039. Epub 2012 Jul 10.
We evaluate the efficiency of an online preoperative assessment service that allows early triage of patients that require further assessment in advance of the clinic and reduces the number of preoperative tests.
We developed a preoperative assessment process where the anesthesiologist collected on-line information without the physical attendance of the patient that included the patient's health history and all the preoperative tests performed in the primary and hospital care. Once confirmed this information by a telephone call, the anesthesiologist identified those patients that required further face to face assessment and limited the number of preoperative tests according to the complexity of the operative procedure and the anesthetic risk. In some procedures trained nursery collected on - line information and in certain cases consulted the anesthesiologist. We compared a cohort of preoperative patients before (2008) and after (2010) developing this online preoperative assessment process. We determined in both periods the number of face to face preoperative assessments and preoperative tests performed. Finally, we compared the cancellation rate in both periods.
5112 elective surgical procedures in 2008 and 6867 elective surgical procedures in 2010 were assessed. In 2010, face to face preoperative assessments dropped to 21%, the number of laboratory tests 15%, the number of electrocardiograms 6% and the number of chest x-rays 1%. The cancellations rate didn't differ between 2008 (2,3%) and 2010 (1.75%).
This preoperative process optimizes the resources reducing the number of face to face preoperative assessments and preoperative tests without increasing the cancellations rate.
我们评估一种在线术前评估服务的效率，该服务可在诊所就诊前对需要进一步评估的患者进行早期分诊，并减少术前检查的数量。
我们制定了一个术前评估流程，麻醉医生在患者无需亲自到场的情况下收集在线信息，包括患者的健康史以及在基层医疗和医院护理中进行的所有术前检查。通过电话确认这些信息后，麻醉医生确定那些需要进一步面对面评估的患者，并根据手术程序的复杂性和麻醉风险限制术前检查的数量。在某些手术中，由经过培训的护士收集在线信息，在某些情况下会咨询麻醉医生。我们比较了在开展这种在线术前评估流程之前（2008年）和之后（2010年）的一组术前患者。我们确定了两个时期进行的面对面术前评估和术前检查的数量。最后，我们比较了两个时期的取消率。
2008年评估了5112例择期手术，2010年评估了6867例择期手术。2010年，面对面术前评估降至21%，实验室检查数量降至15%，心电图数量降至6%，胸部X光数量降至1%。2008年（2.3%）和2010年（1.75%）的取消率没有差异。
这种术前流程优化了资源，减少了面对面术前评估和术前检查的数量，而没有增加取消率。
