Preoperative Systems

  • David Young
  • Gordon Gibby
Part of the Health Informatics book series (HI)

The preoperative period is the time during which critical patient data are gathered, processed, and disseminated. This information is used to plan for and schedule personnel, equipment, and a myriad of subtasks to ensure a smooth day in the OR. The level and the thoroughness of planning determine the efficient utilization of personnel and facilities, which impacts actual costs and, equally important, “frustration costs” to patients and staff. A proper preoperative process contributes significantly to patient safety, decreases institutional costs, and ultimately determines a large portion of the cost of national surgical healthcare. Preoperative patient care is an area of medical specialization that lends itself very readily to the application of the technologic tools of information management. A wise hospital administration will ensure that access to and use of the preoperative informatics system is not restricted to the anesthesiologists but is made available to surgeons, schedulers, equipment technicians, preoperative and postoperative nurses, and supply specialists, so that it provides a finely crafted tool for communication between all of these personnel. In practice, the method of preoperative patient management varies greatly from one institution to another and is determined by budgets, space, available personnel, and historic factors. The four most prevalent preoperative patient evaluation models utilized today are discussed in this chapter.


Preoperative Evaluation Health History Structure Query Language Preoperative Clinic Preoperative Assessment Clinic 
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  1. 1.
    Parker B, Tetzlaff J, Litaker D, et al. Redefining the preoperative evaluation process and the role of the anesthesiologist. J Clin Anesth 2000; 12(5):350–6PubMedCrossRefGoogle Scholar
  2. 2.
    Fischer SP. Development and effectiveness of an anesthesia preoperative evaluation clinic in a teaching hospital. Anesthesiology 1996; 85:196–206PubMedCrossRefGoogle Scholar
  3. 3.
    Correll D, Bader A, Hull M, et al. Value of preoperative clinic visits in identifying issues with potential impact on operating room efficiency. Anesthesiology 2006; 105(6):1254–9PubMedCrossRefGoogle Scholar
  4. 4.
    Gibby G. How preoperative assessment programs can be justified financially to hospital administrators. Int Anesthesiol Clin 2002; 40(2):17–29PubMedCrossRefGoogle Scholar
  5. 5.
    Gibby GL, Paulus DA, Sirota DJ, et al. Computerized pre-anesthetic evaluation results in additional abstracted comorbidity diagnoses. J Clin Monit 1997; 13:35–41PubMedCrossRefGoogle Scholar
  6. 6.
    Stonemetz J, Johns Hopkins Medical Institutions, Baltimore, MD. Personal CommunicationGoogle Scholar
  7. 7.
    Roizen M, Coalson D, Hayward RS, et al. Can patients use an automated questionnaire to define their current health status? Med Care 1992; 30(5 Suppl):MS74–84PubMedCrossRefGoogle Scholar
  8. 8.
    Lutner RE. The automated interview versus the personal interview: Do patient responses to perioperative questions differ? Anesthesiology 1991; 75(3):394–400PubMedCrossRefGoogle Scholar
  9. 9.
    Michota F, Frost S. The preoperative evaluation: Use the history and physical rather than routine testing. Cleve Clin J Med 2004; 71(1):63–70PubMedGoogle Scholar
  10. 10.
    Lucas RW, Card WI, Knill-Jones RP. Computer interrogation of patients. Br Med J 1976; 2(6036):623–5PubMedGoogle Scholar
  11. 11.
    Roizen M. Personal CommunicationGoogle Scholar
  12. 12.
    Pasternak R. Preanesthesia Evaluation of the Surgical Patient, Vol. 24. Philadelphia: The American Society of Anesthesiologists, 1996Google Scholar
  13. 13.
    Cleveland Clinic Foundation's PACE Clinic. Personal CommunicationGoogle Scholar
  14. 14.
    Maurer W, Borkowski R, Parker B. Quality and resource utilization in managing preoperative evaluation. Anesthesiol Clin North Am 2004; 24(1):155–75CrossRefGoogle Scholar
  15. 15.
    Berthelsen C, Stilley KR. Automated personal health inventory or dentistry: Pilot study. J Am Dent Assoc 2000; 131(1):59–66PubMedGoogle Scholar
  16. 16.
    Bachman JW. The patient-computer interview: A neglected tool that can aid the clinician. Mayo Clin Proc 2003; 78(1):67–78PubMedCrossRefGoogle Scholar
  17. 17.
    Gerbert B, Bronstone A, Pantilat S. When asked, patients tell: Disclosure of sensitive health-risk behaviors. Med Care 1999; 37(1):104–11PubMedCrossRefGoogle Scholar
  18. 18.
    US Government. The Americans with Disabilities Act of 1990 (ADA). United States Public Law 101-336, 104 Stat. 327 (July 26, 1990)Google Scholar
  19. 19.
    Campbell KE. Distributed development of a logic-based controlled medical terminology. PhD Thesis, Stanford University, June 1997. Accessed January 30, 2008
  20. 20.
    Rose JS, Kirkley D. Healthcare computer applications and the problem of language: A brief review. Accessed January 30, 2008
  21. 21.
    Tsen LC, Segal S, Pothier M. The effect of alterations in a preoperative assessment clinic on reducing the number and improving the yield of cardiology consultations. Anesth Analg 2002; 95:1563–8PubMedCrossRefGoogle Scholar
  22. 22.
    Vogt A, Henson L. Unindicated preoperative testing: ASA physical status and financial implications. J Clin Anesth 1997; 9:437–41PubMedCrossRefGoogle Scholar
  23. 23.
    Weides S, Lutheran General Hospital, Park Ridge, IL. Personal CommunicationGoogle Scholar
  24. 24. Accessed January 30, 2008Google Scholar

Copyright information

© Springer-Verlag London Limited 2008

Authors and Affiliations

  • David Young
    • 1
  • Gordon Gibby
    • 2
  1. 1.Advocate Lutheran Gener al HospitalChicagoUSA
  2. 2.University of FloridaGainesvilleUSA

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