Evaluation of a protocol for selective ordering of preoperative tests

Area of Science:

• Medical Science
• Clinical Practice
• Healthcare Management

Background:

• Preoperative testing is a standard part of surgical care.
• Over-ordering of preoperative tests can lead to increased costs and potential patient harm.
• Optimizing test selection is crucial for efficient healthcare delivery.

Purpose of the Study:

• To prospectively evaluate a protocol for selective ordering of preoperative tests.
• To assess the clinical utility of omitted tests and the protocol's impact on patient care.
• To determine the acceptability of the selective testing protocol among clinicians.

Main Methods:

• A protocol for selective ordering of 12 preoperative tests was implemented.
• The protocol was based on clinical status and type of surgery.
• 3866 surgical patients were prospectively studied over one year.

Main Results:

• Patients underwent an average of approximately 4 tests each.
• Only 0.4% of omitted tests were deemed potentially useful by criteria, and 0.2% by anaesthetists.
• The protocol had minimal adverse effects on patient care.

Conclusions:

• The selective preoperative testing protocol is effective in reducing unnecessary tests.
• The protocol demonstrates good clinical utility and is acceptable to healthcare providers.
• This approach supports efficient and safe patient management in surgical settings.