Background and Goal of Study:
Surgical procedures can be delayed or cancelled due to inadequate preoperative patient assessment and preparation. Anaesthesia consultation (AC) allows improvement of preoperative patient evaluation and achievement of an appropriate patient scheduling, contributing to reduce case cancellation. Our audit aimed to evaluate the efficacy of AC for urologic patients in our hospital using pre-determined quality indicators (QI).
Materials and Methods:
Retrospective audit to patients undergoing non-emergent urologic surgery at our hospital between October and December 2016. Predetermined QI evaluated: A – Outpatients, American Society of Anaesthesiology physical status (ASA) ≥ 3 or oncologic patients should all have AC (100%);B – Urgent AC request should have AC scheduled in less than 1 month;C – Time interval between AC and surgery (AC-S) should be less than 3 months for ASA ≥3 and oncologic patients;D - All other patients should have AC-S interval of less than 6 months. Surgery (elective, outpatients), AC request (normal, urgent), and previous AC date were collected by patient’s electronic clinical process consultation. Descriptive statistical analysis was conducted using Microsoft® Excel worksheet.
Results:
Included 394 patients: 269 elective (68%) and 125 outpatients (32%). There were 196 patients with AC (50%). Patients with criteria for QI A - 309. From these, 149 had AC (48%) respectively: ASA ≥3 (n=97) – 55 had AC (57%), oncologic patients (n=87) - 37 had AC (43%) and outpatients (n=125) – 57 had AC (46%). There were 160 patients in QI A without AC (52%), in these without AC request n=142 (89%). All patients (n=10) with urgent AC request had AC scheduled in less than 1 month – QI B accomplished in 100%. Time interval AC-S in ASA ≥3 and oncologic patients (n=92) was less than 3 months in 56 patients - QI C accomplished in 61%. From the remaining 104 patients, 85 had surgery in less than 6 months - QI D accomplished in 82%.
Discussion and Conclusion(s): 
One reason for quality indicator A to be less than expected may be failed identification of patients ASA≥3. Surgeons must also be aware of the need for AC for outpatients.  Our action plan is to increase surgeon’s awareness of patient’s criteria for preoperative AC by means of training actions and creation of a quick reference guide table. We hope that compliance with predetermined time intervals can be improved after these training actions.

12 / Evaluation of Quality Indicators in Anaesthesia Consultation for Urologic Surgical Patients