title: The effect of national guidelines on the implementation of outpatient preoperative evaluation clinics in Dutch hospitals.
abstract: OBJECTIVE
  Preoperative evaluation performed by anaesthesiologists primarily aims to estimate the risk of perioperative complications and to create opportunities to optimize the patients' condition before surgery. In this study an inventory was made of the current practice of preoperative evaluation in Dutch hospitals. It was estimated how many hospitals had implemented an outpatient preoperative evaluation clinic in 2004. Subsequently, current practice was compared with the results of a previous inventory (2000). It was also evaluated to what extent the guidelines of the Dutch Health Council and the Netherlands Society of Anaesthesiology were followed.
  
  
  METHODS
  The study consisted of two phases. First, a literature research was performed and pilot interviews were constructed. The interviews were conducted face-to-face with anaesthesiologists in a sample of Dutch hospitals. Based on the results, written questionnaires were constructed. In the second phase these questionnaires were sent to all general and academic hospitals in the Netherlands.
  
  
  RESULTS
  In 2004, 74% of the hospitals had an outpatient preoperative evaluation clinic, compared with 50% in 2000. The percentage of hospitals with an outpatient preoperative evaluation clinic available for all elective patients increased from 20% to 52%.
  
  
  CONCLUSIONS
  The Dutch guidelines on preoperative evaluation seem to have influenced current practice. An increase in the number of outpatient preoperative evaluation clinics was seen after the guidelines were published. The implementation of an outpatient preoperative clinic seems to warrant that anaesthesiologists are carrying out the activities prescribed by the guidelines. Most hospitals without a clinic aim to implement one in the future.
authors.affiliation: University Medical Center Utrecht, Division of Perioperative and Emergency Care, Utrecht, The Netherlands. l.lemmens@umcutrecht.nl
authors.forename: L C
authors.initials: LC
authors.lastname: Lemmens
authors.forename: W A
authors.initials: WA
authors.lastname: van Klei
authors.forename: N S
authors.initials: NS
authors.lastname: Klazinga
authors.forename: C L G
authors.initials: CL
authors.lastname: Rutten
authors.forename: R H
authors.initials: RH
authors.lastname: van Linge
authors.forename: K G M
authors.initials: KG
authors.lastname: Moons
authors.forename: H E M
authors.initials: HE
authors.lastname: Kerkkamp
mesh_terms: D000761:Anesthesia Department, Hospital / Q000592:standards; D000776:Anesthesiology / Q000592:standards* / Q000706:statistics & numerical data; D019983:Guideline Adherence / Q000592:standards* / Q000706:statistics & numerical data; D006284:Health Plan Implementation / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D007407:Interviews as Topic; D009426:Netherlands; D010044:Outpatient Clinics, Hospital / Q000592:standards*; D017410:Practice Guidelines as Topic / Q000592:standards*; D011300:Preoperative Care / Q000592:standards*; D012044:Regression Analysis; D011795:Surveys and Questionnaires