Adequate pre-op assessment in private practice

The recent article by the Advertiser and the AMA demonstrates how poor pre-op assessment can leave anaesthetists in a difficult position on the day of surgery, with poor patient outcomes being possible.

When anaesthetists look after patients in the private sector, there are a number of methods available to assist them in their pre-op assessment.

Firstly, they can perform their pre-op assessment when they first meet the patient on the day of surgery. This means that for any issues that are revealed to the anaesthetist they have little time to gain further information (eg. advice or letters from the patient’s other specialists, or old anaesthetic records).

Plus, if the anaesthetist or patient could have been better prepared (eg. having been sent to one of their specialists to be optimised for surgery, or the anaesthetist being aware of difficulties experienced with previous GAs and more importantly what solved the problems) then the anaesthetist has to make a difficult decision – do they carry on and anaesthetise the sub-optimally prepared patient and potentially do them a disservice, or do they cancel the case until the patient is optimally prepared for their surgery.

There is less tolerance and more open criticism of adverse outcomes that follow proceeding in the sub-optimally prepared patient than there once was, and anaesthetists potentially face a tarnishing of their reputation (or calling their MDO) if they find themselves in this situation.

The alternative of cancelling the case clearly displeases any proceduralist – and who can blame them when if the anaesthetist only performed an adequate pre-op assessment in advance of the day of surgery then the case could have proceeded as planned.

private pre op assessment gone wrong

The other methods to screen patients in the private sector before Anaesthetic Group offered their services was to rely on others – whether it be the private hospital’s pre-admission clinic (when available), the savvy surgeon (who will rarely pick up all issues of relevance to the anaesthetist), or staff the anaesthetist hires (such as a practice nurse) to perform some form of pre-operative health screening. As these all involve non-anaesthetists assessing the patient, they will never be 100% successful in identifying all issues, and the practice nurse option involves significant costs, even when shared amongst a number of anaesthetists.

Anaesthetic Group offers an alternative. It is an inexpensive online approach where patients each complete a pre-operative health questionnaire at a time convenient to them.

This information is instantly communicated to their anaesthetist meaning any further optimisation of the patient can be completed prior to the day of admission. IFC is also addressed in the questionnaire. Because patients are completing the form themselves, this platform improves time management and improves the anaesthetist’s efficiency in preparing for their private lists, giving them more time to work or spend with their families.

Any discussions with patients after the questionnaire is submitted are of a much more professionally satisfying nature, as the anaesthetist is addressing specific issues that have been identified, and not asking about the patient’s allergies etc.

No anaesthetist ever wishes they were less prepared for a list. All Anaesthetic Group paid plans include pre-op assessment – click here to see our see more information on our plans.

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