title: Feedback system to estimate the quality of outpatient preoperative evaluation records: an analysis of end-user satisfaction.
abstract: BACKGROUND
  During preanaesthesia evaluation at an outpatient clinic, information is summarized and structured. We aimed to estimate the effectiveness of this process by determining the proportion of patients presenting for surgery who had valid preoperative anaesthesia assessment records, and also the proportion of patients with a record that contained sufficient information.
  
  
  METHODS
  This study included all non-cardiac surgery procedures performed in adults in 2006 and 2007 in a university hospital. In each case, we asked the anaesthesiologist actually providing anaesthesia to assess the quality of the preoperative record on an electronic feedback form showing a predefined drop down menu and a free text box. The primary outcome was the proportion of procedures with a valid record (< 6 months old) that also contained sufficient and adequate information to safely provide anaesthesia. Secondly, all predefined remarks were assessed for relevance and the proportion of (relevant) remarks per individual anaesthesiologist was calculated.
  
  
  RESULTS
  During the study period, 21 454 procedures were performed. A valid record was available in 20 700 procedures (97%). In 459 (2%) cases, a remark (mostly about not detected comorbidity) was given by the anaesthesia provider, of which 347 (76%) were assessed as 'relevant', resulting in 20 353 (95%) valid records containing sufficient and adequate information. Between individual anaesthesiologists, the percentage remarks ranged from 0.4% to 12.7%.
  
  
  CONCLUSIONS
  On entering the operating theatre, 95% of elective surgery patients had a preanaesthesia evaluation record that contained sufficient and adequate information to safely provide anaesthesia. There was large variability in reporting remarks.
authors.affiliation: Department of Perioperative Care and Emergency Medicine, University MedicalCentre Utrecht, GA Utrecht, The Netherlands. w.a.vanklei@umcutrecht.nl
authors.forename: W A
authors.initials: WA
authors.lastname: van Klei
authors.forename: L M
authors.initials: LM
authors.lastname: Peelen
authors.forename: J E
authors.initials: JE
authors.lastname: Kruijswijk
authors.forename: L
authors.initials: L
authors.lastname: van Wolfswinkel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D015331:Cohort Studies; D015897:Comorbidity; D005246:Feedback; D005260:Female; D006785:Hospitals, University / Q000592:standards; D006801:Humans; D008297:Male; D008499:Medical Records / Q000592:standards*; D008875:Middle Aged; D009426:Netherlands; D010044:Outpatient Clinics, Hospital / Q000592:standards*; D010347:Patient Care Planning / Q000592:standards; D011300:Preoperative Care / Q000592:standards*; D011787:Quality of Health Care; D013997:Time Factors; D055815:Young Adult