Percepção dos pacientes a respeito da utilidade do Ambulatório de Avaliação Pré-anestésica em um país caribenho em desenvolvimento

Seetharaman Hariharan; Deryk Chen; Nicholas Jurai; Amanda Partap; Rakesh Ramnath; Dinesh Singh

doi:10.1590/S0034-70942009000200007

Scientific Article

Percepção dos pacientes a respeito da utilidade do Ambulatório de Avaliação Pré-anestésica em um país caribenho em desenvolvimento

Patient perception of the utility of the Preanesthetic Clinics in a caribbean developing country

Seetharaman Hariharan; Deryk Chen; Nicholas Jurai; Amanda Partap; Rakesh Ramnath; Dinesh Singh

http://dx.doi.org/10.1590/S0034-70942009000200007 Braz J Anesthesiol, vol.59, n2, p.194-205, 2009

PDF

Downloads: 0

Resumo

JUSTIFICATIVA E OBJETIVOS: A percepção dos pacientes a respeito da utilidade do Ambulatório de Avaliação Pré-anestésica e o fluxo de pacientes não foram extensamente estudados no mundo em desenvolvimento. O objetivo deste estudo foi analisar esse aspecto. MÉTODO: Foi realizada pesquisa aplicando-se questionário entre pacientes atendidos no Ambulatório de Avaliação Pré-anestésica de um hospital terciário de ensino em Trinidad. A título de comparação, esse questionário também foi distribuído aos pacientes atendidos no Ambulatório de Cirurgia Geral. Os parâmetros demográficos, incluindo idade, sexo, nível escolar e estado físico ASA foram anotados. Outros dados registrados incluíam o fluxo de pacientes e detalhes a respeito da equipe médica. RESULTADOS: Dos 220 pacientes atendidos no Ambulatório de Avaliação Pré-anestésica, 92,7% participaram do estudo. A validade do questionário foi apoiada pelo coeficiente alfa de Cronbach (0,67). O tempo médio para o encaminhamento do Ambulatório de Cirurgia para a Clínica Pré-anestésica foi de 50 dias; a espera média na clínica foi de 2,7 horas e da espera pela intervenção cirúrgica após a aceitação pelo ambulatório foi de 13 dias. As opiniões dos pacientes a respeito dos benefícios da clínica e tempo de espera não foram influenciadas pela idade nem pelo nível educacional. Na opinião dos pacientes, o atendimento no Ambulatório de Avaliação Pré-anestésica foi satisfatório, mas os tempos de espera foram considerados longos. CONCLUSÕES: Na opinião dos pacientes, a consulta no Ambulatório de Avaliação Pré-anestésica antes do procedimento cirúrgico foi útil e o atendimento foi considerado satisfatório.

Palavras-chave

AVALIAÇÃO, Pré-anestésica

Abstract

BACKGROUND AND OBJECTIVES: Perception of the patients regarding the utility of the Preanesthetic Clinics and flow time in clinics has not been widely studied in the developing world. The present study aims to study this aspect. METHODS: A self-administered 15-item questionnaire survey was conducted among patients attending the Preanesthetic Clinics at a tertiary care teaching hospital in Trinidad. The questionnaire was also distributed to the patients attending the General Surgical Clinic for comparison. Another questionnaire was distributed among the staff of the Preanesthetic Clinic. Patient demographics including age, gender, and educational status and American Society of Anesthesiologists physical status were noted. Other data recorded were patient flow time and details of attending staff. RESULTS: Of the 220 patients who attended the Preanesthetic Clinics, 92.7% participated in the study. The reliability of the questionnaire was supported by Cronbach's alpha coefficient (0.67). The median time for referral from the surgical clinic to Preanesthetic Clinic was 50 days, median waiting time in the clinic was 2.7 hours, and the median waiting time for surgery after acceptance in the clinic was 13 days. The patients' opinions regarding the benefits of the clinic, length of the waiting time was independent of their age and educational status. Patients felt that attending the Preanesthetic Clinic was beneficial and not costly to them, although the waiting times were found to be longer. CONCLUSIONS: Patients perceive that attending the Preanesthetic Clinic has been useful before the surgical procedure and the care they received in the clinic was satisfactory

Keywords

EVALUATION, Pre-anesthetic

Referencias

Pollard JB, Garnerin P. Outpatient preoperative evaluation clinic can lead to a rapid shift from inpatient to outpatient surgery: a retrospective review of perioperative setting and outcome. J Clin Anesth. 1999;11:39-45.

Practice advisory for preanesthesia evaluation. Anesthesiology. 2002;96:485-496.

Haberkern CM, Lecky JH. Preoperative assessment and the anesthesia clinic. Anesthesiol Clin North Am. 1996;14:609-30.

Fisher SP. Development and effectiveness of an anesthesia preoperative evaluation clinic in a teaching hospital. Anesthesiology. 1996;85:196-206.

Correll DJ, Bader AM, Hull MW. Value of preoperative clinic visits in identifying issues with potential impact on operating room efficiency. Anesthesiology. 2006;105:1254-1259.

van Klei WA, Moons KG, Rutten CL. The effect of outpatient preoperative evaluation of hospital inpatients on cancellation of surgery and length of hospital stay. Anesth Analg. 2002;94:644-649.

Lee JA. The anesthetic outpatient clinic. Anaesthesia. 1949;4:169-174.

Lee A, Hillman KM. Anaesthesia preoperative evaluation clinic: III. Anesthesiology. 1997;86:260-263.

Hariharan S, Chen D, Merritt-Charles L. Evaluation of the utilization of the preanaesthetic clinics in a University Teaching Hospital. BMC Health Serv Res. 2006;6:59.

Pollard JB, Zboray AL, Mazze RI. Economic benefits attributed to opening a preoperative evaluation clinic for outpatients. Anesth Analg. 1996;83:407-410.

Starsnic MA, Guarnieri DM, Norris MC. Efficacy and financial benefit of an anesthesiologist-directed university preadmission evaluation center. J Clin Anesth. 1997;9:299-305.

St Jacques PJ, Higgins MS. Beyond cancellations: decreased day of surgery delays from a dedicated preoperative clinic may provide cost savings. J Clin Anesth. 2004;16:478-479.

Edward GM, Lemaire LC, Preckel B. Patient experiences with the Preoperative Assessment Clinic (PEPAC): validation of an instrument to measure patient experiences. Br J Anaesth. 2007;99:666-672.

Edward GM, Biervliet JD, Hollmann MW. Comparing the organisational structure of the preoperative assessment clinic at eight university hospitals. Acta Anaesthesiol Belg. 2008;59:33-37.

Kopp VJ. Preoperative preparation: Value, perspective, and practice in patient care. Anesthesiol Clin North Amer. 2000;18:551-574.

Hariharan S, Merritt-Charles L, Chen D. Patient perception of the role of anesthesiologists: a perspective from the Caribbean. J Clin Anesth. 2006;18:504-509.

Edward GM, de Haes JC, Oort FJ. Setting priorities for improving the preoperative assessment clinic: the patients' and the professionals' perspective. Br J Anaesth. 2008;100:322-326.

Dexter F. Design of appointment systems for preanesthesia evaluation clinics to minimize patient waiting times: a review of computer simulation and patient survey studies. Anesth Analg. 1999;89:925-931.

Edward GM, Razzaq S, de Roode A. Patient flow in the preoperative assessment clinic. Eur J Anaesthesiol. 2008;25:280-286.

Edward GM, Das SF, Elkhuizen SG. Simulation to analyse planning difficulties at the preoperative assessment clinic. Br J Anaesth. 2008;100:195-202.

Ferschl MB, Tung A, Sweitzer B. Preoperative clinic visits reduce operating room cancellations and delays. Anesthesiology. 2005;103:855-859.

Holt NF, Silverman DG, Prasad R. Preanesthesia clinics, information management, and operating room delays: results of a survey of practicing anesthesiologists. Anesth Analg. 2007;104:615-618.

Pollard JB, Olson L. Early outpatient preoperative anesthesia assessment: does it help to reduce operating room cancellations?. Anesth Analg. 1999;89:502-505.

van Klei WA, Hennis PJ, Moen J. The accuracy of trained nurses in pre-operative health assessment: results of the OPEN study. Anaesthesia. 2004;59:971-978.

Percepção dos pacientes a respeito da utilidade do Ambulatório de Avaliação Pré-anestésica em um país caribenho em desenvolvimento

Patient perception of the utility of the Preanesthetic Clinics in a caribbean developing country

Seetharaman Hariharan; Deryk Chen; Nicholas Jurai; Amanda Partap; Rakesh Ramnath; Dinesh Singh

Resumo

Palavras-chave

Abstract

Keywords

Referencias

Links

compartir

Braz J Anesthesiol