Pre-anesthetic assessment clinics in Ontario.
OBJECTIVE
To survey the provision of pre-anesthetic assessment clinics in hospitals in Ontario during the summer of 1997.


METHODS
Mail survey questionnaire of all 300 hospitals in Ontario.


RESULTS
Replies were received from 260 hospitals (86.7%) of which 131 provide anesthesia. Of these, 86% are community and 14% teaching hospitals. Regular clinics are held in 63% of these hospitals, most commonly daily. As to location, 73% are held in the outpatient department. Written guidelines detailing which patients should be referred are issued by 77% of departments. The attending surgeon is the most common source of referral (64%). Referred patients are most commonly seen by a nurse (52%) who decides on onward referral to an anesthesiologist. Services generating the most referrals are general surgery (83%), orthopedics (64%) and obstetrics/gynecology (49%). In 47% of hospitals 10-50 patients are seen per month and they travel most commonly up to 100 km. The average "no show" rate is 6.2%. Only 36% of departments assess patients the same day as seen by the surgeon. On attending the clinic, 51% can see an internist the same day in contrast to 30% being able to see a cardiologist. Pre-admission testing is available to 97% on the same day. Direct funding is available for the nurse (87%), physician (1%) and secretarial help (43%). Remuneration of the anesthesiologist is fee for service (99%) and sessional (1%).


CONCLUSIONS
Pre-anesthetic assessment clinics are common in Ontario. More development is required to enable patients to receive all aspects of their preoperative assessment during one visit.
Bond
D M
DM
Department of Anaesthesia, Queen's University, Kingston General Hospital, ON, Canada. dmbond@hotmail.com
D000761:Anesthesia Department, Hospital / Q000191:economics / Q000458:organization & administration*; D000776:Anesthesiology / Q000191:economics; D002202:Capital Financing; D002309:Cardiology; D018588:Fee-for-Service Plans; D013502:General Surgery; D013509:Gynecologic Surgical Procedures; D006764:Hospitals, Community / Q000458:organization & administration; D006784:Hospitals, Teaching / Q000458:organization & administration; D006801:Humans; D007388:Internal Medicine; D008505:Medical Staff, Hospital; D009741:Nursing Staff, Hospital; D013513:Obstetric Surgical Procedures; D009864:Ontario; D019637:Orthopedic Procedures; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration; D017410:Practice Guidelines as Topic; D012017:Referral and Consultation; D013514:Surgical Procedures, Operative; D011795:Surveys and Questionnaires; D014187:Transportation of Patients; D000078329:Workforce