Abbott TEF, Fowler AJ, Dobbs TD, Harrison EM, Gillies MA, Pearse RM. Frequency of surgical treatment and related hospital procedures in the UK: a national ecological study using hospital episode statistics. Br J Anaesth. 2017; 119:(2)249-257

Dhatariya KK, Wiles MD. Pre-operative testing guidelines: a NICE try but not enough. Anaesthesia. 2016; 71:(12)1403-1407

Elliott T, Tong I, Sheridan A, Lown BA. Beyond convenience: patients' perceptions of physician interactional skills and compassion via telemedicine. Mayo Clin Proc Innov Qual Outcomes. 2020; 4:(3)305-314

European Parliament, Council of the European Union. General data protection regulation. 2018. (accessed 6 September 2021)

General Medical Council. Decision making and consent. Guidance on professional standards and ethics for doctors. 2020. (accessed 6 September 2021)

Gilmartin J. Nurse-led pre-admission clinics. In: Timmins F, McCabe C (eds). London: Wiley; 2008

Gray R, Sanders C. A reflection on the impact of COVID-19 on primary care in the United Kingdom. J Interprof Care. 2020; 34:(5)672-678

Greenhalgh T, Wherton J, Shaw S, Morrison C. Video consultations for covid-19. BMJ. 2020; 368

Grocott MPW, Pearse RM. Perioperative medicine: the future of anaesthesia?. Br J Anaesth. 2012; 108:(5)723-726

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries. Br J Anaesth. 2016; 117:(5)601-609

Ireland S, Kent B. Telephone pre-operative assessment for adults: a comprehensive systematic review. JBI Library Syst Rev. 2012; 10:(25)1452-1503

Joseph A, Malik JS, Rajendram R. Telephone pre-assessment prior to elective surgery: the potential impact. General Surgeon. 2020; 2:(1016)

Khuri SF, Daley J, Henderson W The National Veterans Administration surgical risk study: risk adjustment for the comparative assessment of the quality of surgical care. J Am Coll Surg. 1995; 180:(5)519-531

Kruse CS, Krowski N, Rodriguez B, Tran L, Vela J, Brooks M. Telehealth and patient satisfaction: a systematic review and narrative analysis. BMJ Open. 2017; 7:(8)

Lozada MJ, Nguyen JTC, Abouleish A, Prough D, Przkora R. Patient preference for the pre-anesthesia evaluation: telephone versus in-office assessment. J Clin Anesth. 2016; 31:145-148

Macfarlane AJR. What is clinical governance?. BJA Educ. 2019; 19:(6)174-175

McKinstry B, Watson P, Pinnock H, Heaney D, Sheikh A. Confidentiality and the telephone in family practice: a qualitative study of the views of patients, clinicians and administrative staff. Fam Pract. 2009; 26:(5)344-350

Medical Defence Union. Conducting remote consultations. 2020. (accessed 6 September 2021)

Medical Protection Society. COVID-19 and remote consultations—how we can help. 2021. (accessed 6 September 2021)

National Institute for Health and Care Excellence. Perioperative care in adults. NICE guideline NG180. 2020. (accessed 6 September 2021)

Owens WD, Felts JA, Spitznagel EL ASA physical status classifications: a study of consistency of ratings. Anesthesiology. 1978; 49:(4)239-43

Ray KN, Felmet KA, Hamilton MF Clinician attitudes toward adoption of pediatric emergency telemedicine in rural hospitals. Pediatr Emerg Care. 2017; 33:(4)250-257

Ritchie J, Spencer L. Qualitative data analysis for applied policy research. In: Bryman A, Burgess R (eds). London: Routledge; 1994

Sokol D, Car J. Protecting patient confidentiality in telephone consultations in general practice. Br J Gen Pract. 2006; 56:(526)384-385

Stiggelbout AM, Van der Weijden T, De Wit MP Shared decision making: really putting patients at the centre of healthcare. BMJ. 2012; 344

Yen C, Tsai M, Macario A. Preoperative evaluation clinics. Curr Opin Anaesthesiol. 2010; 23:(2)167-172

Enhancing the utility of virtual surgical pre-assessment

23 September 2021
12 min read
Volume 30 · Issue 17


During the COVID-19 pandemic, virtual pre-assessment was introduced for all elective and semi-urgent surgeries to maintain surgical clinical services in the authors' Trust. This mainly involved telephone pre-assessments, although occasionally video technology was used. This had to be managed and maintained at a distance with little or no training or established method. This article includes experiences of staff involved in a single tertiary centre, an assessment of the pros and cons of virtual pre-assessment and concludes with a set of recommendations to enhance the utility of the service for the future.

The main purpose of surgical pre-assessment is the risk/benefit evaluation and patient optimisation to minimise surgical and anaesthesia risks, to reduce the length of hospital stay and to enhance patient recovery (Khuri et al, 1995) on a platform of shared decision making (Stiggelbout et al, 2012). This is a major component of perioperative medicine dedicated to enhance surgical outcomes (Grocott and Pearse, 2012).

Traditionally, surgical pre-assessment has involved a focused history and a clinical assessment pertinent to the surgical specialty at a face-to-face meeting. It included a careful evaluation to identify those patients at high risk of complications. Additional investigations were organised when required, specialist opinions were requested in complex situations and the patient's condition optimised within the available timeframe, especially if the surgery was urgent.

Amid the increasing demand for operations and other invasive procedures, organising pre-assessment clinic appointments has become a strenuous burden due to limited hospital resources (Abbott et al, 2017). Therefore, telephone pre-assessment was developed as a tool that could reduce costs while improving patient experience and attendance and relieving overcrowding and patient anxiety at pre-assessment clinics (Lozada et al, 2016). However, little was known about its efficacy in achieving the goals of patient satisfaction (based on patient feedback) and surgical productivity (Yen et al, 2010).

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