A call centre and extended checklist for pre-screening elective surgical patients – a pilot study

Area of Science:

• Anesthesiology
• Health Services Research

Background:

• Novel approaches are needed for preoperative assessment to ensure sustainable, high-quality surgical services.
• A call centre model with electronic checklists and phone follow-up was evaluated as an alternative to clinic visits.

Purpose of the Study:

• To examine the benefits of a call centre-based preoperative assessment system.
• To determine the feasibility of bypassing traditional preoperative clinics for elective non-cardiac surgery patients.

Main Methods:

• A pilot study involved 193 patients undergoing elective non-cardiac surgery.
• A Computer-assisted Health Assessment by Telephone (CHAT) was used for initial screening, followed by anaesthetist review and optional follow-up calls.
• Expert anaesthetists assessed the suitability of call centre-only assessment for hypothetical procedures of varying complexity.

Main Results:

• The mean CHAT assessment time was 19.8 minutes; 45.6% of cases required anaesthetist follow-up calls.
• Anaesthetists spent an average of 3.8 minutes on summary review and calls.
• 89% of procedural anaesthetists believed the call centre assessment alone was sufficient for cholecystectomy.
• Senior anaesthetists deemed 79-97% of patients suitable to bypass clinics for cataract, cholecystectomy, or hip replacement surgeries.

Conclusions:

• A call centre pre-screening system has the potential to substantially reduce patient numbers attending preoperative anaesthetic assessment clinics.
• Further research is indicated to rigorously assess the quality and safety of this innovative approach.