Utility of history and physical updates for ambulatory otolaryngic surgery

Laryngoscope. 2008 Jan;118(1):165-8. doi: 10.1097/MLG.0b013e3181565989.

Abstract

Objectives/hypothesis: Preoperative assessment is intended to identify anesthetic risk and a patient's appropriateness to undergo a proposed surgery. The timing of these assessments varies among institutions. In our ambulatory surgery center, preoperative reassessments were initially performed within 30 days of surgery (group A). Recently, this changed to require reassessments within 7 days of surgery (group B). Now, the policy mandates a preoperative reassessment within 24 hours (group C). We evaluate whether there are differences in surgical cancellations based on these new reassessment intervals.

Study design: Retrospective operative log and chart review.

Methods: We identified 1,108 cases representative of group A. The rate of surgical cancellations for this group was compared with that of the 3,705 cases in group B and the 1,060 cases in group C. Differences were evaluated with a chi test.

Results: Total cancellation rates for groups A, B, and C were 3.0%, 3.3%, and 3.9%, respectively (P = .51). Cancellations secondary to a history and physical examination findings during these preoperative reassessment periods were 0.81%, 0.38%, and 0.66% for groups A, B, and C, respectively (P = .15).

Conclusions: Cancellation rates for patients undergoing ambulatory otolaryngic surgery based on preoperative reassessment intervals of 30 days, 7 days, and 24 hours were similar.

MeSH terms

  • Ambulatory Surgical Procedures* / statistics & numerical data
  • Appointments and Schedules*
  • Humans
  • Medical History Taking*
  • Organizational Policy
  • Otorhinolaryngologic Surgical Procedures* / statistics & numerical data
  • Patient Dropouts / statistics & numerical data
  • Physical Examination*
  • Retrospective Studies
  • Surgicenters / organization & administration
  • Time Factors