Pre-operative clinics are essential in preparing patients for surgery, systematically evaluating fitness, minimizing last-minute cancellations, and improving outcomes. While all types aim to enhance patient safety, the setup, staffing, and delivery models of pre-operative clinics vary widely, from nurse-led evaluations to consultant reviews, remote screenings, same-day assessments, and multidisciplinary approaches.
Many hospitals run nurse-led pre-operative services where specialist nurses assess a patient’s suitability for anesthesia and surgery. These structured evaluations cover medical history, medication use, lifestyle factors, and risk elements such as smoking. Nurses provide pre-surgery guidance on fasting and medication adjustments and refer complex cases for anesthesia consultations. Appointments usually last one to two hours and may include basic investigations such as blood tests or ECGs 1–3.
For higher-risk patients or complex procedures, anesthesia provider-led pre-operative clinics provide in-depth evaluation and surgical planning. Here, experienced anesthetists assess comorbidities, refine risk mitigation strategies, and coordinate with other specialists as needed. These services often complement nurse-led clinics, ensuring patients with greater needs receive advanced pre-operative oversight 4.
Some pre-operative assessments are delivered through specialized models tailored to patient needs and surgical complexity. For straightforward cases, same-day assessment clinics offer streamlined evaluations within outpatient departments, thereby balancing convenience with safety through careful eligibility screening.
Patients with more complex health profiles (like multiple chronic conditions or advanced age) may benefit from multidisciplinary pre-operative clinics, where internal medicine specialists, geriatricians, anesthesiologists, nurse practitioners, and nurses work together to optimize health, address underlying issues, and coordinate specialty care.
In academic and tertiary centers, dedicated institutional anesthesia clinics provide comprehensive pre-operative workups across a range of surgical specialties, assessing functional status, integrating with internal medicine teams, and serving as important training environments for residents in peri-operative medicine 8–12.
To accommodate patients who cannot attend in person or when the risk level is low, many facilities use telephone or virtual triage clinics. These assessments still include structured interviews to collect medical history, medication lists, and lifestyle information, identifying those needing in-person review. These approaches tend to be efficient for low-risk cases and help prioritize clinic resources 5–7.
Pre-operative clinics are critical components of modern surgical care, designed to identify risks, improve efficiency, and enhance patient safety. The primary models include nurse-led clinics, anesthesia-led clinics, specialized clinics such as same-day, multidisciplinary medicine, and dedicated institutional anesthesia clinics, as well as remote options. Each type serves different patient populations and clinical scenarios, and aligning the assessment model to patient risk ensures both safety and effective resource use in peri-operative care.
References
1. Arun, N. et al. Nurse-run preanaesthesia assessment clinics: an initiative towards improving the quality of perioperative care at the ambulatory care centre. BMJ Open Qual 10, (2021). DOI: 10.1136/bmjoq-2020-001066
2. Terry, D., Hills, D., Bradley, C. & Govan, L. Nurse-led clinics in primary health care: A scoping review of contemporary definitions, implementation enablers and barriers and their health impact. J Clin Nurs 33, 1724–1738 (2024). DOI: 10.1111/jocn.17003
3. Pu, X., Malik, G. & Murray, C. Nurses’ experiences and perceptions of running nurse‐led clinics: A scoping review. Int J Nurs Pract 30, e13285 (2024). DOI: 10.1111/ijn.13285
4. Cantlay, K. L., Baker, S., Parry, A. & Danjoux, G. The impact of a consultant anaesthetist led pre-operative assessment clinic on patients undergoing major vascular surgery. Anaesthesia 61, 234–239 (2006). DOI: 10.1111/j.1365-2044.2005.04514.x
5. Jonker, P. et al. Alternatives to the in-person anaesthetist-led preoperative assessment in adults undergoing low-risk or intermediate-risk surgery. Eur J Anaesthesiol 40, 343–355 (2023). DOI: 10.1097/EJA.0000000000001815
6. Keshock, M. & Cummings, K. Preoperative Process: Phone Triage, Preoperative Clinic, or Virtual Patient Visits. in Perioperative Medicine: A Problem-Based Learning Approach (eds. Richman, D. C. et al.) 0 (Oxford University Press, 2025). DOI:10.1093/med/9780190902001.003.0001.
7. Di Biase, M., van der Zwaard, B., Aarts, F. & Pieters, B. Pre-operative triAge proCedure to streaMline elective surgicAl patieNts (PACMAN) improves efficiency by selecting patients eligible for phone consultation. Eur J Anaesthesiol 41, 813–820 (2024). DOI: 10.1097/EJA.0000000000002055
8. Liu, S. et al. Preoperative assessment clinics and case cancellations: a prospective study from a large medical center in China. Ann Transl Med 9, 1501 (2021). DOI: 10.21037/atm-21-4665
9. Pre-Op Urgent Care: Your First Step Before Surgery – Sahara West. https://saharawesturgentcare.com/blog/pre-op-urgent-care-your-first-step-before-surgery/ (2024).
10. Pre-Operative Medicine Clinic | OHSU. https://www.ohsu.edu/pre-operative-medicine-clinic.
11. Bader, A. M., Sweitzer, B. & Kumar, A. Nuts and bolts of preoperative clinics: the view from three institutions. Cleve Clin J Med 76 Suppl 4, S104-111 (2009). DOI: 10.3949/ccjm.76.s4.17
12. Edwards, A. F. & Slawski, B. Preoperative Clinics. Anesthesiol Clin 34, 1–15 (2016). DOI: 10.1016/j.anclin.2015.10.002