Research Mentor Name

George McKelvey, PhD

Research Mentor Email Address

geomckelvey@gmail.com

Institution / Department

Department of Anesthesiology, The Detroit Medical Center

Document Type

Research Abstract

Research Type

other

Other Type of Research

Quality Improvement

Graduate Level Research

no

Abstract

Background: Preoperative anxiety affects 40–80% of surgical patients and is associated with poorer perioperative experiences. Despite evidence linking preoperative anxiety to increase postoperative pain, sleep disturbances, morbidity and delayed recovery, structured anxiety assessment is not routinely integrated into outpatient pre-anesthesia workflows. The Amsterdam Preoperative Anxiety and Information Scale (APAIS) is a validated tool that quantifies patient anxiety and information needs. This quality improvement (QI) project aims to implement APAIS screening in a Pre-Anesthesia Testing (PAT) clinic and evaluate its feasibility, workflow integration, and acceptability.

Methods: This QI initiative will be conducted in adult elective surgery patients at the Detroit Medical Center PAT Clinic. During the implementation phase, all patients will complete the APAIS at check-in. Patients who screen positive for elevated anxiety or information needs will receive a brief, structured counseling intervention delivered by trained anesthesia personnel, including clarification of the anesthetic plan and tailored perioperative education.

Implementation success will be assessed using process measures (proportion of eligible patients screened, APAIS completion documented in the EMR), balancing measures (staff workflow burden, time to complete screening), and patient-centered feedback on acceptability. Outcome measures for a planned second phase, including postoperative pain and patient satisfaction, is planned but not reported in this QI phase.

Results: Implementation of APAIS screening in the PAT clinic, data collection, analysis and tracking process measures are pending IRB approval. These assessments aim to inform the establishment of a standardized, patient-centered preoperative anxiety screening process.

Conclusion: The aim of this QI project is to implement standardized preoperative anxiety screening using APAIS and provide structured counseling for patients with elevated anxiety or information needs, while assessing feasibility, workflow integration, and acceptability. By achieving these aims, the project seeks to establish a sustainable, patient-centered screening process in the PAT clinic and lay the groundwork for a future phase evaluating its impact on postoperative outcomes.

Disciplines

Anesthesiology | Medicine and Health Sciences | Psychiatry | Quality Improvement

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