Het preoperatieve ‘papieren consult’: soms een prima alternatief

In the Netherlands, the majority of elective-surgery patients are evaluated by the anaesthesiologist at the preoperative assessment clinic. We believe that this visit can be omitted in selected patients as it has only minimal benefit, whereas its disadvantages can be substantial. Alternatively, the initial screening could be performed by the completion of a questionnaire via the telephone, via internet, by a nurse or by the surgeon. These data can then be evaluated by the anaesthesiologist; this is called the ‘paper-based’ preoperative evaluation. This method does require the conscientious cooperation between anaesthesiologists and surgeons; it should be clear which patients are eligible, what type of anaesthetic technique should be used, how the patient should be informed and how the informed consent is obtained. In our opinion, this paper-based evaluation combines safety and efficiency with patient-friendliness. It should be anchored in current guidelines to ensure quality.

Conflict of interest: as a chairman, A.P. Wolff received payment from the Dutch Order of Medical Specialists for the development of national guidelines on perioperative safety and grants for two multicentre studies on the implementation of the national guideline, ‘The Preoperative Path’, from ZonMw (the Netherlands Organisation for Health Research and Development). G.J. Scheffer has received compensation from Vither for consultancy, from the Court for an expert testimony and for writing books, and received a grant from Philips. Financial support for this article: none declared.