[Impact of preoperative outpatient evaluation clinic on performance indicators.].

BACKGROUND AND OBJECTIVES This study aimed at evaluating the effects of implementing a Preoperative Outpatient Evaluation Clinic (POEC) based on operating center performance indicators. METHODS The following data were prospectively followed for five years: total POEC evaluations and surgeries performed; total and reasons for surgeries cancellation; inpatient or outpatient surgeries performed; procedures cancellation rate and mean hospital stay of admitted patients. Reasons for procedure cancellations were divided in medical and administrative reasons. Cancellation rate is presented in percentage. Mean hospital stay is presented in days. Other indicators are presented in total figures. The study was divided in five periods: Pre-POEC, POEC 1, 2, 3 and 4, corresponding, respectively, to the years of 1998, 1999, 2000, 2001 and 2002. For each year, indicators percentage was compared to previous year and to the year Pre-POEC. Reasons were defined to check interactions among indicators. RESULTS Except for total performed procedures, POEC has improved all tracked indicators. This improvement was low at the beginning and more significant in the year POEC 4. There has been decrease in the total number of cancelled procedures due to administrative reasons. There was also a decrease in procedures cancellation rate and mean hospital stay. These decreases were progressive and more marked in POEC 4. There is correlation (r = 0.977) between procedures cancellation rate and mean stay of admitted patients. CONCLUSIONS There are significant changes in indicators. Improvement is gradual and progressive as years go by with regard to POEC development, and positively affects indicators improvement.