Presentation Details
| Enhanced Surgical Outcomes Associated with the Introduction of Pre-operative Medical Clinic T.Gage Branham1, Brennan McCullar1, Blake Daniels1, Nathaniel Stoikes1, Ravpreet Gill1, Sai K Bhogadi1, Guy Voeller1, David Webb1, Megan Reece1, William Cloud1, Jennifer Tat2, Sabrina Shivani2, Huibo Shao1. 1Baptist Memorial Hospital-Memphis, Memphis, TN, USA.2University of Tennessee Heath Science Center, Memphis, TN, USA |
Abstract
BACKGROUND: There has been an increased demand from hospitals and providers to perform more complex surgeries on sicker patients, with the scope of surgical techniques allowing procedures on patients once considered non-surgical candidates. This trend has led to an increased focus on the importance of perioperative medicine in surgical patients over the last two decades. Historically at our institution, outpatient surgical cases were evaluated by nurses with minimal physician oversight and minimal opportunity for optimization prior to surgery. This study evaluates the impact of establishing a physician-led clinic on improved surgical outcomes by standardizing the perioperative approach through the implementation of evidence-based practices.
METHODS: Memphis Pre-Optimization Clinic (MPOC) was introduced in October 2022, implementing standardized, multidisciplinary protocols for elective surgery cases. Key outcomes, including cost, length of stay (LOS), readmissions, mortality, and Patient Safety Indicators (9-13), were tracked via EMR. We compared MPOC patients (N=1,139; 7/1/24 - 12/31/24) to historical pre-anesthesia evaluation controls (PAE; N=947; 7/1/22 - 12/31/22). Regression analysis was performed by a certified institutional statistician.
RESULTS: MPOC patients had an 84% reduction in readmissions compared to PAE patients (P value <0.05). MPOC patients had a 54% reduction in mortality, though not statistically significant. No significant cost differences between the comparison groups were observed. Although not statistically significant, MPOC patients had improved clinical outcomes in all other quality measures except for DVT/PE.
CONCLUSIONS: A pre-operative optimization clinic increases healthcare value by reducing readmission rates while maintaining costs.
No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author.
METHODS: Memphis Pre-Optimization Clinic (MPOC) was introduced in October 2022, implementing standardized, multidisciplinary protocols for elective surgery cases. Key outcomes, including cost, length of stay (LOS), readmissions, mortality, and Patient Safety Indicators (9-13), were tracked via EMR. We compared MPOC patients (N=1,139; 7/1/24 - 12/31/24) to historical pre-anesthesia evaluation controls (PAE; N=947; 7/1/22 - 12/31/22). Regression analysis was performed by a certified institutional statistician.
RESULTS: MPOC patients had an 84% reduction in readmissions compared to PAE patients (P value <0.05). MPOC patients had a 54% reduction in mortality, though not statistically significant. No significant cost differences between the comparison groups were observed. Although not statistically significant, MPOC patients had improved clinical outcomes in all other quality measures except for DVT/PE.
CONCLUSIONS: A pre-operative optimization clinic increases healthcare value by reducing readmission rates while maintaining costs.
No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author.
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