Do preoperative clinics improve operating room efficiency

EALTH CARE CHANGES in the United States in the last decade have mandated close evaluation of the efficiency and cost benefit of many hospital programs. Economic changes have decreased reimbursement and reduced the patient's length of stay in the hospital. At the same time, there has been a rapid advancement in outpatient services, especially in ambulatory surgery. 1'2 The increasing percentage of surgical patients entering the hospital as outpatients or admitted on the same day as surgery continues to challenge perioperative personnel, especially the anesthesiologist. Physicians are the primary decision makers regarding the use of health care services. In preparing a patient for surgery, physicians are directly responsible for providing and ordering virtually all of the patient evaluations, preoperative diagnostic testing, and referrals to specialists. Although health care continues to be in an active state of reform, it frequently is difficult for an individual physician or group to change the manner or routine of clinical practice patterns. However, the evolution of health care now demands that providers demonstrate verifiable evidence of cost reductions while maintaining productivity and a high quality of patient care.