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BJA Advance Access originally published online on January 31, 2008
British Journal of Anaesthesia 2008 100(3):322-326; doi:10.1093/bja/aem393
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2008. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Setting priorities for improving the preoperative assessment clinic: the patients' and the professionals' perspective

G. M. Edward1, J. C. J. M. de Haes2, F. J. Oort2, L. C. Lemaire1, M. W. Hollmann1,* and B. Preckel1

1 Department of Anaesthesiology, University of Amsterdam, PO Box 22700, 1100 DE Amsterdam, The Netherlands
2 Department of Medical Psychology, Academic Medical Centre, University of Amsterdam, PO Box 22700, 1100 DE Amsterdam, The Netherlands

* Corresponding author. E-mail: m.w.hollmann{at}amc.uva.nl

Background: The quality of the preoperative assessment clinic (PAC) is determined by many factors. Patients’ experiences are important indicators, but often overlooked. We prepare to set priorities to improve the PAC by obtaining detailed patients’ feedback on the quality of the PAC, and establishing the value patients and professionals attach to different care aspects, using the Patient Experiences with the Preoperative Assessment Clinic questionnaire.

Methods: The PAC’s standard of service was determined for five care aspects (dimensions), using patients’ feedback. The importance of a dimension to patients was determined by calculating the effects of the dimensions on patients’ overall appraisal. In addition, professionals were asked to rate the importance of the different care aspects.

Results: Patients had the most positive experiences with the nurse, and the least positive experiences with waiting. However, waiting was least important to patients. When combining the PAC’s standard of service with the value given to the dimensions by patients and professionals separately, we found in both instances that waiting was in greatest need of improvement. This was followed by reception, the anaesthetist, remaining experiences, and finally the nurse.

Conclusions: Quality improvement of the PAC can be achieved by obtaining patients’ feedback on the quality, determine a PAC’s standard of service, recognize service areas that require improvement, and identify actions appropriate to bring about improvement. The value patients and professionals attach to different aspects of care can then be used to prioritize improvements.

Keywords: anaesthesia, audit; assessment, preanaesthetic; research, anaesthesia; screening; surgery, preoperative period


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