Feasibility of a Risk-Based Approach to Cataract Surgery Preoperative Medical Evaluation.

Area of Science:

• Ophthalmology
• Healthcare Management
• Medical Informatics

Background:

• The Patients Over Paperwork initiative allows healthcare facilities to set their own preoperative history and physical requirements.
• A risk-based approach to preoperative evaluations may enhance patient care efficiency and value.
• Cataract surgery is a common procedure where optimizing preoperative processes is beneficial.

Purpose of the Study:

• To evaluate the feasibility of a risk-based preoperative medical evaluation for cataract surgery.
• To assess the safety and throughput of a virtual, risk-based preoperative assessment strategy.
• To determine if a streamlined approach impacts patient outcomes and operational efficiency.

Main Methods:

• A pilot study implemented a virtual medical history questionnaire for risk assessment in cataract surgery patients.
• The intervention group (June-September 2020) proceeded to surgery without further preoperative evaluation if deemed low-risk.
• A preintervention control group (January-December 2019) received standard preoperative care for comparison.

Main Results:

• No significant differences were observed in intraoperative complications, 7-day emergency department visits, or inpatient admissions between groups.
• The intervention group showed significantly fewer case delays compared to the control group (0.6% vs 1.9%).
• Rates of same-day cancellations were similar between the intervention and control groups.

Conclusions:

• A virtual, risk-based preoperative evaluation for cataract surgery is a safe and efficient model.
• This approach can be encouraged for healthcare systems and ambulatory surgery centers to tailor preoperative requirements.
• Findings support optimizing preoperative care pathways for low-risk surgical patients.