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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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References

Health Council of the Netherlands: Committee on Preoperative Evaluation.Preoperative evaluation [in Dutch].Rijswijk, The Netherlands: Health Council of the Netherlands, 1997: 11–37.
Fischer S. Development and effectiveness of an anesthesia preoperative evaluation clinic in a teaching hospital. Anesthesiology 1996; 85: 196–206.Google Scholar
Pollard JB, Garnerin P, Dalman RL. Use of outpatient preoperative evaluation to decrease length of stay for vascular surgery. Anesth Analg 1997; 85: 1307–1311.Google Scholar
Roizen MF, Foss JF, Fischer SP. Preoperative evaluation. In: Miller RD, ed. Anesthesia.New York, USA: Churchill Livingstone, 2000: 824–883.
van Klei WA, Moons KG, Rutten CLet al. The effect of outpatient preoperative evaluation of hospital inpatients on cancellation of surgery and length of hospital stay. Anesth Analg 2002; 94: 644–649.Google Scholar
van Klei WA, Grobbee DE, Rutten CLGet al. Role of history and physical examination in preoperative evaluation. Eur J Anaesthesiol 2003; 20: 612–618.Google Scholar
Lew E, Pavlin DJ, Amundsen L. Outpatient preanaesthesia evaluation clinics. Singapore Med J 2004; 45: 509–516.Google Scholar
Ferschl MB, Tung A, Sweitzer B, Huo D, Glick DB. Preoperative clinic visits reduce operating room cancellations and delays. Anesthesiology 2005; 103: 855–859.Google Scholar
Netherlands Society of Anaesthesiology. Viewpoint on preoperative care [in Dutch]. In: Viewpoints of the Netherlands Society of Anaesthesiology.Utrecht, The Netherlands: Netherlands Society of Anaesthesiology, 2002: 8–9.
van Klei WA, Moons KGM, Rheineck-Leyssius ATet al. Validation of a clinical prediction rule to reduce preoperative type and screen procedures. Br J Anaesth 2002; 89: 221–225.Google Scholar
van Klei WA, Moons KGM, Leyssius ATR, Knape JTA, Rutten CLG, Grobbee DE. A reduction in type and screen: preoperative prediction of RBC transfusions in surgery procedures with intermediate transfusion risks. Br J Anaesth 2001; 87: 250–257.Google Scholar
van Klei W, Rutten C, Moons K, Lo B, Knape J, Grobbee D. Limited effect of Health Council guideline on outpatient preoperative evaluation clinics in the Netherlands: an inventory [in Dutch]. Ned Tijdschr Geneeskd 2001; 145: 25–29.Google Scholar
Halaszynski TM, Juda R, Silverman DG. Optimizing postoperative outcomes with efficient preoperative assessment and management. Crit Care Med 2004; 32: S76–S86.Google Scholar
van Klei WA. Optimizing the benefits of outpatient preoperative anesthesia evaluation – in response. Anesth Analg 2002; 95: 1461–1462.Google Scholar
van Klei WA, Hennis PJ, Moen J, Kalkman CJ, Moons KG. The accuracy of trained nurses in pre-operative health assessment: results of the OPEN study. Anaesthesia 2004; 59: 971–978.Google Scholar
Rutten CL, Post D, Smelt WL. Outpatient preoperative examination by the anesthesiologist. I. Fewer procedures and preoperative hospital days [in Dutch]. Ned Tijdschr Geneeskd 1995; 139: 1028–1032.Google Scholar
Vaghadia H, Fowler C. Can nurses screen all outpatients? Performance of a nurse based model. Can J Anaesth 1999; 46: 1117–1121.Google Scholar
Boldt J. Shortage of anaesthesiologists in Germany [in German]. Anasthesiol Intensivmed Notfallmed Schmerzther 2003; 38: 384–388.Google Scholar
Pontone S, Brouard N, Scherpereel P, Boulardl G, Arduin P. Demography of French anaesthesiologists. Results of a national survey by the French College of Anaesthesiologists (CFAR) and the French National Society of Anaesthesia and Intensive Care (SFAR), supported by the National Institute for Demographic Studies (INED). Eur J Anaesthesiol 2004; 21: 398–407.Google Scholar
Schubert A, Eckhout G, Cooperider T, Kuhel A. Evidence of a current and lasting national anesthesia personnel shortfall: scope and implications. Mayo Clin Proc 2001; 76: 995–1010.Google Scholar
Baele P, Dercq JP, Smets D, Somer A, Desantoine D. Can we predict the future evolution of anesthesiology workforce in Belgium? Acta Anaesthesiol Belg 1998; 49: 205–220.Google Scholar