ArticleQuality in health care : QHC1998
Description of local adaptation of national guidelines and of active feedback for rationalising preoperative screening in patients at low risk from anaesthetics in a French university hospital.
Article in Quality in health care : QHC, 1998. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Awareness of adapting clinical practice guidelines to a local context.Clinical and public health guidelines · 2025Article
- Locally adapted guidelines: a scoping review.Systematic reviews · 2025Article
- Creating computable algorithms for symptom management in an outpatient thoracic oncology setting.Journal of pain and symptom management · 2013Article
- Evaluating compliance with institutional preoperative testing guidelines for minimal-risk patients undergoing elective surgery.BioMed research international · 2013Article
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9 authors.
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Abstract
objectiveTo describe the effect of local adaptation of national guidelines combined with active feedback and organisational analysis on the ordering of preoperative investigations for patients at low risk from anaesthetics.
designAssessment of preoperative tests ordered over one month, before and after local adaptation of guidelines and feedback of results, combined with an organisational analysis.
settingMotivated anaesthetists in 15 surgical wards of Bordeaux University Hospital, Region Aquitain, France. SUBJECTS: 42 anaesthetists, 60 surgeons, and their teams.
main outcome measuresNumber and type of preoperative tests ordered in June 1993 and 1994, and the estimated savings.
resultsOf 536 patients at low risk from anaesthetics studied in 1993 before the intervention 80% had at least one preoperative test. Most (70%) tests were ordered by anaesthetists. Twice the number of preoperative tests were ordered than recommended by national guidelines. Organisational analysis indicated lack of organised consultations and communication within teams. Changes implemented included scheduling of anaesthetic consultations; regular formal multidisciplinary meetings for all staff; preoperative ordering decision charts. Of 516 low risk patients studied in 1994 after the intervention only 48% had one or more preoperative tests ordered (p < 0.05). Estimated mean (SD) saving for one year if changes were applied to all patients at low risk from anaesthesia in the hospital 3.04 (1.23) mFF.
conclusionsA sharp decrease in tests ordered in low risk patients was found. The likely cause was the package of changes that included local adaptation of national guidelines, feedback, and organisational change.
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