Development of clinical practice guidelines for preoperative investigation at Paholplpayuhasena Hospital

Abstract

Background: Preoperative investigations are a part of preanasthetic evaluation. Preoperative investigations were found to be beneficial and cost-effective by following the guideline. At Paholpolpayuhasena Hospital found a lot of inappropriate preoperative investigations. Objectives: To evaluate the proportion of patient who adhered to the guidelines before and after introduction of the preoperative investigation guideline and analyze the cost reduction. Methods: Prospective study was done. The data were collected from medical record in two periods: April 1,2014 – May 31,2014 (pre-guideline) and August 1,2014 – September 30, 2014 (post-guideline). Results: There were 926 patients, pre-guideline 449 patients and post-guideline 477 patients. Proportion of patients whose preoperative investigation was done follow the guideline increased from 11.1% to 54.5% (p < 0.001) and cost of inappropriate investigation decreased from 98,530 baht to 49,700 baht Conclusion: The study showed that proportion of patient who adhered to the guideline increased significantly and the cost of unnecessary investigations deceased.