Premium
Perioperative processes and outcomes after implementation of a hospitalist‐run preoperative clinic
Author(s) -
Vazirani Sondra,
LankaraniFard Azadeh,
Liang LiJung,
Stelzner Matthias,
Asch Steven M.
Publication year - 2012
Publication title -
journal of hospital medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.128
H-Index - 65
eISSN - 1553-5606
pISSN - 1553-5592
DOI - 10.1002/jhm.1968
Subject(s) - medicine , perioperative , hospital medicine , perioperative medicine , preoperative care , retrospective cohort study , tertiary care , medline , emergency medicine , anesthesia , political science , law
BACKGROUND: A structured, medical preoperative evaluation may positively impact the perioperative course of medically complex patients. Hospitalists are in a unique position to assist in preoperative evaluations, given their expertise with inpatient medicine and postoperative surgical consultation. OBJECTIVE: To evaluate specific outcomes after addition of a Hospitalist‐run, medical Preoperative clinic to the standard Anesthesia preoperative evaluation. DESIGN, SETTING, PATIENTS: A pre/post retrospective, comparative review of outcomes of 5223 noncardiac surgical patients at a tertiary care Veterans Administration (VA) medical center. RESULTS: Length of stay was reduced for inpatients with an American Society of Anesthesia (ASA) score of 3 or higher ( P < 0.0001). There was a trend towards a reduction in same‐day, medically avoidable surgical cancellations (8.5% vs 4.9%, P = 0.065). More perioperative beta blockers were used ( P < 0.0001) and more stress tests were ordered ( P = 0.012). Inpatient mortality rates were reduced (1.27% vs 0.36%, P = 0.0158). CONCLUSION: A structured medical preoperative evaluation may benefit medically complex patients and improve perioperative processes and outcomes. Journal of Hospital Medicine 2012. © 2012 Society of Hospital Medicine