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The effect of national guidelines on the implementation of outpatient preoperative evaluation clinics in Dutch hospitals

Published online by Cambridge University Press:  19 June 2006

L. C. Lemmens ,
W. A. van Klei ,
N. S. Klazinga ,
C. L. G. Rutten ,
R. H. van Linge ,
K. G. M. Moons  and
H. E. M. Kerkkamp
L. C. Lemmens
Affiliation:
University Medical Center Utrecht, Division of Perioperative and Emergency Care, Utrecht, The Netherlands
W. A. van Klei
Affiliation:
University Medical Center Utrecht, Division of Perioperative and Emergency Care, Utrecht, The Netherlands
N. S. Klazinga
Affiliation:
Academic Medical Center, Department of Social Medicine, Amsterdam, The Netherlands
C. L. G. Rutten
Affiliation:
Weezenlanden Hospital, Isala Clinics, Department of Anaesthesiology, Zwolle, The Netherlands
R. H. van Linge
Affiliation:
University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands
K. G. M. Moons
Affiliation:
University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands
H. E. M. Kerkkamp
Affiliation:
University Medical Center Utrecht, Division of Perioperative and Emergency Care, Utrecht, The Netherlands
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Abstract

Summary

Background and objectives: Preoperative evaluation performed by anaesthesiologists primarily aims to estimate the risk of perioperative complications and to create opportunities to optimize the patients' condition before surgery. In this study an inventory was made of the current practice of preoperative evaluation in Dutch hospitals. It was estimated how many hospitals had implemented an outpatient preoperative evaluation clinic in 2004. Subsequently, current practice was compared with the results of a previous inventory (2000). It was also evaluated to what extent the guidelines of the Dutch Health Council and the Netherlands Society of Anaesthesiology were followed. Methods: The study consisted of two phases. First, a literature research was performed and pilot interviews were constructed. The interviews were conducted face-to-face with anaesthesiologists in a sample of Dutch hospitals. Based on the results, written questionnaires were constructed. In the second phase these questionnaires were sent to all general and academic hospitals in the Netherlands. Results: In 2004, 74% of the hospitals had an outpatient preoperative evaluation clinic, compared with 50% in 2000. The percentage of hospitals with an outpatient preoperative evaluation clinic available for all elective patients increased from 20% to 52%. Conclusions: The Dutch guidelines on preoperative evaluation seem to have influenced current practice. An increase in the number of outpatient preoperative evaluation clinics was seen after the guidelines were published. The implementation of an outpatient preoperative clinic seems to warrant that anaesthesiologists are carrying out the activities prescribed by the guidelines. Most hospitals without a clinic aim to implement one in the future.

Keywords

PRACTICE GUIDELINES, anaesthesiaPREOPERATIVE CAREAMBULATORY CARETHE NETHERLANDS
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 23 , Issue 11 , November 2006 , pp. 962 - 970
Copyright
2006 European Society of Anaesthesiology

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