The economic and resource pressures in contemporary healthcare have resulted in a number of changes in clinical practice. These include increased use of day case (ambulatory surgery), various domiciliary post-acute care systems and the development of preadmission clinics to facilitate hospital admission on the day of surgery. The aims of the preadmission clinic:
• reduction in bed occupancy and thus a shorter hospital stay;
• less disruption to patient's routine;
• development of guidelines for laboratory investigations to reduce ordering of unnecessary laboratory tests;
• adequate time exists between consultation and surgery for the relevant tests to be performed and the results obtained;
• fewer 'last minute' cancellations because of abnormal test results;
• education of patient (and family) regarding proposed surgery and preparation of a plan for anaesthesia and analgesia;
• to facilitate the use of the hospital for acute care only and to encourage the management of long-term health problems by community-based health services such as general practitioners or out-patient specialist appointments.
Where geographical distance precludes attendance of the patient at a central preadmission clinic, the process can be undertaken by a local medical officer or peripheral hospital with the information faxed or E-mailed to the central hospital where surgery is to be undertaken.
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