[From a small-scale to a whole-system approach: the "Preoperative route" guideline]

A 2007 report by the Dutch Health Care Inspectorate concluded that there were many deficiencies in the organization of preoperative care in the Netherlands, in particular a lack of coordination and poor patient information. A new national Guideline on Preoperative Care advises on how to best organize preoperative care, but purposely refrains from prescribing specific preoperative diagnostic workup strategies or prophylactic therapies. The author examines some factors that hamper coordination between the various hospital departments involved in the preoperative process.