The preoperative evaluation form: assessment of quality from one hundred thirty-eight institutions and recommendations for a high-quality form.

STUDY OBJECTIVE: To develop a rating system to evaluate the preoperative evaluation form in three categories: informational content, ease of use, and ease of reading; to analyze forms contributed by the Association of Anesthesia Clinical Directors; to offer an example of a more optimal form; and interest practitioners in evaluating the quality of their evaluation forms. SETTING: University medical center. DESIGN/MEASUREMENTS: The informational content of the forms was graded by a rating system developed to give a score based on the importance of the data to anesthesia management and legal documentation. Based on the amount of informational content, the forms were grouped into categories ranging from severely deficient to excellent. The ease of use and ease of reading were determined by specific criteria. MAIN RESULTS: 138 forms were analyzed. The mean +/- SD information score was 265 +/- 41, with a range of 140 to 333 (maximum score possible = 363). Fifteen percent of the forms were considered severely deficient to substandard whereas 52% were deemed very good to excellent. A large proportion of forms omitted at least one essential information item. Twelve percent and 6% were labeled poor with regard to ease of use and ease of reading, respectively. Academic centers performed significantly better in the content and ease of use of their forms compared to those from private centers. CONCLUSIONS: A good preoperative evaluation form is an important tool in the anesthetic management of a patient and plays a significant role in the medical legal arena. We found that a surprisingly high percentage of forms are missing important information. A form that contains all of the information and also meets our ease of use and reading standards was developed and offered as an example.