To audit and assess the cost effectiveness and patient satisfaction of an orthopaedic pre-admission clinic.

A pre-admission clinic for patients undergoing elective orthopaedic surgery has been in use in our hospital for the past 3 years. We audited the activities of this clinic over a period of 1 year and also assessed the cost effectiveness and patient satisfaction over the study period. Over 1 year, 2391 patients were invited and 2167 (90. 63 %) attended the clinic.

Patients’ satisfaction was assessed using a multidimensional questionnaire which included information on time spent with patients by doctors and nurses and communication, facilities, patient involvement and overall quality of the clinic. Patient cancellation and deferring of surgery was also calculated. Cost of bed blocking due to cancellation following admission and cost of theatre time was also calculated.

During the 1 year period, the non-attendance rate was 9. 37 % (224 patients). The cancellation rate following admission was 3. 4% (75 patients). 270 patients (11. 3%) had their surgery postponed due to medical and social reasons. Of the 2167 patients, 1822 (84%) had their surgery performed as scheduled. Thirty percent of the patients were unaware that they would be seen by both doctors and nurses. All the patients were satisfied with time spent with them and the information given regarding the surgery. 90% of the attending patients rated the service as excellent to good. Based on average cost of one night stay and overnight bed blocking and theatre time, this clinic has saved over £200, 000 for the Trust. The pre-admission clinic for elective orthopaedic surgery is not only cost effective but also reduces the ward-based workload for the junior doctors.