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A nurse-led telephone screening initiative to identify low-risk elective orthopaedic surgery patients to improve pre-anesthesia clinic efficiency

Greer L Barlow, Kimberley McIltrot, Zeina Khouri Stevens, Hala Sunbul


Rationale, aims, and objectives: All patients scheduled for elective orthopaedic surgery are seen by an anaesthesiologist routinely in the pre-anesthesia clinic as part of their standard pre-operative evaluation. This study aimed to assess the potential to reduce the number of elective orthopaedic surgery patients seen in the pre-anesthesia clinic, using a registered nurse (RN)-led pre-operative process to identify low-risk patients as part of a sensitive, individualized and caring approach.

Method: This quality improvement study was performed across the orthopaedic services outpatient population, in a tertiary healthcare centre in Saudi Arabia. A simple ‘yes/no’ questionnaire was developed and utilized over a 3-month period to identify the low-risk adult patient population and determine if a pre-anesthesia clinic visit was necessary.

Results: Among a sample of 193 patients, 36 (18.7%) were assessed as healthy and did not require an anaesthesiologist evaluation in the pre-anesthesia clinic.

Conclusions: All elective orthopaedic surgery patients do not require a routine pre-anesthesia visit prior to their surgery. Pre-operative care should be tailored to the needs of each individual patient. This study demonstrates how an RN can improve the utilization of the pre-anesthesia clinic by using a validated screening tool and reduce the number of pre-anesthesia visits in the interests of individual patients and health services efficiency.


Clinic efficiency, elective orthopaedic surgery, electronic health records, individualization, nurse telephone screening, person-centered healthcare, pre-anesthesia clinic, pre-operative assessment programs, protocol implementation, quality improvement, t

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