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How to rationalize preoperative tests? A method to implement local guidelines successfully.

Stéphanie Suria1, Hakim Harkouk1, Alexandre Eghiaian1

  • 1Service d'anesthésie, Gustave-Roussy Cancer Campus, 94805 Villejuif, France.

Anaesthesia, Critical Care & Pain Medicine
|December 30, 2015
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Summary
This summary is machine-generated.

Implementing a protocol for preoperative tests (PTs) significantly reduced excessive testing, with 91% adherence to guidelines. This successful method improved preoperative screening efficiency and reduced costs.

Keywords:
Anaesthesia auditAuditPre-anaesthesia assessment

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Area of Science:

  • Medical guidelines
  • Healthcare management
  • Surgical protocols

Background:

  • Preoperative screening traditionally involves clinical examination and tests.
  • Systematic prescription often leads to an excessive number of preoperative tests.
  • This study assessed a protocol-guided approach to preoperative test prescription.

Purpose of the Study:

  • To evaluate the success of implementing a protocol-guided prescription procedure for preoperative tests (PTs).
  • To compare the number of PTs prescribed before and after the implementation of local guidelines.
  • To determine the impact of a new protocol on preoperative testing practices.

Main Methods:

  • Developed and implemented local guidelines for PTs based on French Society of Anaesthesia recommendations.
  • Utilized sociologic concepts to facilitate protocol adherence during implementation.
  • Analyzed PT prescriptions for scheduled surgeries (excluding children and emergencies) in 2011 (before) and 2013 (after).

Main Results:

  • Analyzed 292 patient files (157 in 2011, 135 in 2013).
  • Achieved 91% adherence to recommendations in 2013.
  • Significantly decreased excessive preoperative test prescribing from 20.7% to 7.1% (P<0.0001), reducing costs.

Conclusions:

  • Observed excellent adherence to the preoperative test prescription protocol.
  • The sociologic implementation method proved successful in guiding PT prescriptions.
  • Long-term evaluation is recommended to confirm sustained results.