Evidence map›Paper›PMID 39052992›Full record

ArticleJMIR perioperative medicine2024

Preoperative Anesthesia Virtual Video Consultations in a Preadmission Clinic: Quality Improvement Study.

Yamini Subramani, Jill Querney, Priyanka Singh, Yifan Zhang, Lee-Anne Fochesato, Nida Fatima, Natasha Wood, Mahesh Nagappa

Abstract read
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In one paragraph

Article in JMIR perioperative medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Trial
  2. Trial
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Yamini Subramani *Department of Anesthesia and Perioperative Medicine, London Health Sciences Centre, St. Joseph Health Care, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.ORCID https://orcid.org/0000-0002-2050-4324
Jill Querney *Department of Anesthesia and Perioperative Medicine, London Health Sciences Centre, St. Joseph Health Care, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.ORCID https://orcid.org/0000-0002-0366-3200
Priyanka Singh *Department of Anesthesia and Perioperative Medicine, London Health Sciences Centre, St. Joseph Health Care, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.ORCID https://orcid.org/0009-0003-4981-9586
Yifan Zhang *Department of Anesthesia and Perioperative Medicine, London Health Sciences Centre, St. Joseph Health Care, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.ORCID https://orcid.org/0009-0005-6663-4262
Lee-Anne Fochesato *Department of Anesthesia and Perioperative Medicine, London Health Sciences Centre, St. Joseph Health Care, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.ORCID https://orcid.org/0000-0001-7751-098X
Nida Fatima *Department of Anesthesia and Perioperative Medicine, London Health Sciences Centre, St. Joseph Health Care, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.ORCID https://orcid.org/0009-0004-3834-9651
Natasha Wood *Department of Nursing, London Health Sciences Centre, Western University, London, ON, Canada.ORCID https://orcid.org/0009-0002-0282-8189
Mahesh Nagappa *Department of Anesthesia and Perioperative Medicine, London Health Sciences Centre, St. Joseph Health Care, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.ORCID https://orcid.org/0000-0001-8036-3319

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe preadmission clinic (PAC) is crucial in perioperative care, offering evaluations, education, and patient optimization before surgical procedures. During the COVID-19 pandemic, the PAC adapted by implementing telephone visits due to a lack of infrastructure for video consultations. While the pandemic significantly increased the use of virtual care, including video appointments as an alternative to in-person consultations, our PAC had not used video consultations for preoperative assessments.

objectiveThis study aimed to develop, implement, and integrate preoperative video consultations into the PAC workflow.

methodsA prospective quality improvement project was undertaken using the Plan-Do-Study-Act (PDSA) methodology. The project focused on developing, implementing, and integrating virtual video consultations at London Health Sciences Centre and St. Joseph Health Care (London, Ontario, Canada) in the PAC. Data were systematically collected to monitor the number of patients undergoing video consultations, address patient flow concerns, and increase the percentage of video consultations. Communication between the PAC, surgeon offices, and patients was analyzed for continuous improvement. Technological challenges were addressed, and procedures were streamlined to facilitate video calls on appointment days.

resultsThe PAC team, which includes professionals from medicine, anesthesia, nursing, pharmacy, occupational therapy, and physiotherapy, offers preoperative evaluation and education to surgical patients, conducting approximately 8000 consultations annually across 3 hospital locations. Following the initial PDSA cycles, the interventions consistently improved the video consultation utilization rate to 17%, indicating positive progress. With the onset of PDSA cycle 3, there was a notable surge to a 29% utilization rate in the early phase. This upward trend continued, culminating in a 38% utilization rate of virtual video consultations in the later stages of the cycle. This heightened level was consistently maintained throughout 2023, highlighting the sustained success of our interventions.

conclusionsThe quality improvement process significantly enhanced the institution's preoperative video consultation workflow. By understanding the complexities within the PAC, strategic interventions were made to integrate video consultations without compromising efficiency, morale, or safety. This project highlights the potential for transformative improvements in health care delivery through the thoughtful integration of virtual care technologies.

Indexed as

assessmentconsultationdigital healtheMedicinehospitalimplementationintegrationonline healthperioperative medicinepreadmission clinicpreoperativepreoperative evaluationremoteremote consultationsafetysurgerytelehealthtelemedicinevideo consultationvirtual careworkflow

Identifiers

PMID39052992
PMCPMC11310641

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.