The Pre-Anesthesia Evaluation Center (PEC) at NewYork-Presbyterian/Weill Cornell Medical Center is an integral part of a patient’s peri-procedural journey. The PEC team combs through the patients’ medical records to gather information from various sources on past and current health conditions. This information is organized and documented for the day-of-procedure anesthesia care team. Patients are frequently contacted to clarify their health status and are advised on perioperative medication management and preoperative interventions to optimize their outcome.
Detail-oriented data collation by the PEC team contributes in several ways:
- Identification of potential health factors that may need to be optimized prior to surgery
- Mitigation of anesthetic risk during a procedure
- Optimization of a patient’s health before, during, and after procedure
- Decrease day-of-surgery cancellations
While the vast majority of patients can be cared for by the PEC team with chart review and phone call, the PEC also offers in-person visits. These more personalized visits can offer an opportunity for patients to be evaluated by one of our expert team members, ask questions directly to an anesthesiologist about the plan for their care, discuss any concerns they may have, and have relevant lab testing conveniently done in our clinic.
PEC by the Numbers
Due to the expert care from our pre-anesthesia team, the day-of-surgery rate rescheduling at Weill Cornell Medicine due to lack of medical optimization is less than 0.1%. This is well below the national average of 4-12%.
Last year, the PEC team reviewed >70,000 patient charts to facilitate their safe and timely care.
The outstanding PEC team is staffed by 14 nurse practitioners, 5 nurses, 1 medical-surgical technician and 2 business associates. There are 9 attending anesthesiologists who rotate through staff the clinic full time, performing consultations, answering questions, talking to patients, and facilitating optimization of patients’ health status.
Expanding Role of Pre-Anesthesia Clinic
The PEC is an important layer in the safety net of being able to deliver world-class care throughout the peri-procedural time period. Because anesthesia can be affected by any organ-system, we recognize the value of understanding all of the health issues a patient is experiencing, not only the ones that are technically relevant to the surgery.
We are also building a risk optimization toolbox to facilitate best decision-making, ensuring that patients are getting the most cutting-edge care. For example, patients receive text messages about what medications they need to hold prior to their procedures. A new matrix offers guidance to proceduralists on what pre-procedural testing is recommended to ensure that patients are neither over- or under-tested prior to a procedure. Next we are expanding optimization programs (which have been shown to improve outcomes) in the areas of iron deficiency anemia, frailty, and smoking cessation.