Beyond the algorithm: Implementation of a hospitalist-led pre-operative clinic assessment before cardiac surgery

With the growth of dedicated pre-operative clinics in recent decades, patients have access to formalized and rigorous assessments in the days to weeks before surgery. The hallmark of pre-operative evaluations is cardiac risk stratification before non-cardiac surgery, yet any organ system has the potential to be addressed or further optimized before surgery. A formal, global clinic-based risk assessment before cardiac surgery seems to be a novel pre-operative clinic practice pattern, especially for a hospitalist-led preoperative medicine clinic. In July 2014, the Pre-Operative Medicine Clinic (PMC) within the Division of Hospital Medicine at Oregon Health & Science University began to formally assess patients before cardiac surgery. Here, we aim to describe our first year's experience with this patient population and report on its efficacy and practicality.