Fiona Fletcher, Rachel Tibble, Fatima Eltinay, Angela Gent
Royal Derby Hospital, Derby, United Kingdom
Uttoxeter Road, Derby DE22 3NE
Introduction: Setting up a Virtual Anaesthetic Review (VAR) clinic at the Royal Derby Hospital was aimed at improving efficiency of pre-operative assessment (POA) for complex patients (ASA 3 /4) by allowing increased numbers to be reviewed per clinic compared with face-to-face clinics, and more patients to be offered Day Surgery by default. The team of clinical nurse practitioner and Consultant Anaesthetist provided a truly virtual clinic when the Consultant Anaesthetist was at home with Covid-19.
Methods: We looked at the number of patients reviewed in the VAR Clinic in Derby since its inception and compared this to potential numbers achieved by face-to-face assessment. The complexity and ASA grade of patients are documented and the flexibility of the clinic to continue even if not based in the hospital, via secure computer links to hospital servers examined.
Results: The VAR has reviewed 177 pre-operative patients for Day Surgery in 16 weekly clinics since December 2022. For face-to-face clinics for the same duration only 72 patients would have been seen. 8/177 (4.5%) were ASA 2 and thus 169/177 (95.5%) were ASA 3 or 4. 12 patients were reviewed when the Consultant Anaesthetist was off-site using communication via phone and computer.
Conclusions: Our VAR clinic has highlighted a 140% increase in patient numbers reviewed pre-operatively. These were mainly ASA 3 or 4 so increases the accessibility to Day Surgery for these complex patients and, also allows flexibility to easily change clinic times or work remotely without inconveniencing patients and allowing reviews to go ahead.