Even a Child of Four Could Do It!a Maximizing Efficiency in a Preoperative Clinic Using the Patient-Centered Anesthesia Triage System
Preoperative evaluation (POE) and preparation of the surgical patient has received increased interest over the past decade, first with the growing awareness of Enhanced Recovery After Surgery programs,1–4 and more recently, with the concept of the Perioperative Surgical Home,5–7 as promoted by the American Society of Anesthesiologists. Although surgical patients have always received a thorough evaluation by anesthesiologists before surgery, this frequently happens in the hours immediately before surgery, with no opportunity to identify and correct comorbid conditions. All too often we recognize that a patient is poorly prepared (A1c of 9) but proceed to surgery to avoid the financial penalty of an unbooked operating room, significant inconvenience for the patient who may have taken time off work, and so on. It is nearly impossible to tie poor preparation to a poor outcome in a single patient, but studies have demonstrated improved outcomes in patients who have a visit to an anesthesiology-led preoperative clinic.