Preoperative Anesthesia Automatic System:a Retrospective Cohort Study (PACMAN)

The Preoperative Anesthesia automatiC systeM for triAge and screeNing (PACMAN) as a Model for Recognition of Patients Who May Screened by Phone: a Retrospective Cohort Study

To evaluate of PACMAN triage system is able to discern patient who may be safely screened by phone

Study Overview

• Status: Completed
• Conditions: Anesthesia; Surgical Procedure, Unspecified; Assessment

Detailed Description

PACMAN triage system consists of a health questionnaire and an algorithm. Patient were called up by registered nurses and asked to answer the questionnaire. Patients answers were applied to PACMAN algorithm to determine what kind of screening patient should receive: in person or by phone.

• Study Type: Observational
• Enrollment (Actual): 1019

Contacts and Locations

Study Locations

• Netherlands
  • Brabant
    • 's-Hertogenbosch, Brabant, Netherlands, 5200 ME
      • Jeroen Bosch ziekenhuis

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Patients scheduled for all kind of surgical procedures except cardiac surgery and intracranial surgery

Description

Inclusion Criteria:

• >18 years old, scheduled for elective clinical interventions under procedural sedation and all types of elective medium or low risk surgery with anaesthetic guidance, as defined by the European Society of Anaesthesia (ESA) guidelines.

Exclusion Criteria:

• <18 years. Patients scheduled for emergency and high-risk surgery were excluded as the policy of our department dictates that these patients must always be seen in person, according to ESA guidelines.

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Reduction of the number of in person consultations	In 2019 all patients were screened in person. Aim of the study is to evaluate whether implementation of PACMAN leads to a significant reduction of the number of in person consultations	between start inclusion and 6 months after start inclusion

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Reliability of PACMAN	Reliability of the triage procedure was evaluated by verifying the PACMAN outcome (PhC vs in-PC) against the assigned ASA-PS classification. Patients scheduled for a PhC were considered to be accurately triaged if classified ASA-PS I-II or III with stable comorbidities. Patients scheduled for an in-PC were considered to be accurately triaged if classified ASA-PS III with unstable comorbidities or IV.	between start inclusion and 6 months after start inclusion
Patients outcome	To measure the impact of PACMAN on patient outcomes we evaluated the occurrence of perioperative unanticipated adverse events (UAE). An anaesthesia-related UAE was defined as an event causing mortality or morbidity, occurring during the perioperative period or up to seven days after surgery and requiring special medical treatment or prolongation of hospitalisation beyond the expected length of stay. Data concerning perioperative UAE were collected by reviewing the EMR of patients who had undergone surgery.	between start inclusion and 6 months after start inclusion
Cost-effectiveness	we examined cost-effectiveness and efficiency by determining the time taken by screening staff for a single PhC or in-PC and the average number of patients screened before and after implementation of PACMAN along with related staff costs.	between start inclusion and 6 months after start inclusion

Collaborators and Investigators

• Sponsor: Jeroen Bosch Ziekenhuis
• Investigators: Principal Investigator: Barbe Pieters, Dr.PhD, Jeroen Bosch Hospital, 's Hertogenbosch The Netherlands

Study record dates

Study Major Dates

• Study Start (Actual): October 1, 2021
• Primary Completion (Actual): November 1, 2021
• Study Completion (Actual): June 1, 2022

Study Registration Dates

• First Submitted: November 20, 2023
• First Submitted That Met QC Criteria: November 20, 2023
• First Posted (Actual): November 28, 2023

Study Record Updates

• Last Update Posted (Actual): November 28, 2023
• Last Update Submitted That Met QC Criteria: November 20, 2023
• Last Verified: November 1, 2023

More Information

Terms related to this study

• Keywords: Anaesthetists / Health Care Surveys / Preoperative Care / Triage
• Other Study ID Numbers: 2021.08.06.01

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No