A model of community based, preadmission management for elective surgical patients

This paper outlines the process of preadmission elective surgical preparation utilised at our institution.

The process commences with a health status questionnaire sent to all patients. Based on the results of the questionnaire all elective surgical patients are then triaged: (i) to be assessed by an appropriately accredited general practitioner (45% of elective surgical patients) and subsequently attend preadmission clinic; (ii) to be seen by an anaesthetist (25%) and also be preadmitted at this visit or (iii) to go directly to preadmission clinic (30%).

This has resulted in a 96% same day admission rate for all elective surgery. Cancellations due to suboptimally prepared patients are < 1%. The involvement of general practitioners in this process has reduced patient inconvenience. There has been marked improvement in the ability to admit patients on the same day of surgery for all types of surgery while minimising late cancellations. This has been achieved at a minimum real cost.

Preanaesthetic assessment is important for patient well-being and hospital throughout. We describe a system for utilising non-anaesthetist general practitioners in this process. Their familiarity with their own patients and appropriate training in preoperative assessment significantly contributes to the efficiency of our elective surgical throughput.