SWAPNet Pre-anaesthetic Evaluation Framework

Initiative Type
23 January 2018
Last updated
17 August 2019


Pre-operative assessment is an important component of the peri-operative management of elective surgery patients and ideally should occur following referral for surgery. Effective, planned, organised preparation results in the delivery of safe, high quality healthcare, improved theatre efficiency and positive patient experiences.

The SWAPNet, Pre-Anaesthetic Evaluation Framework (sponsored by the Clinical Excellence Division) aims to deliver safe, high quality healthcare and improve the efficiency of service delivery and patient outcomes through the utilisation of a suite of resources to support the appropriate and effective triage and assessment of patients undergoing procedures requiring anaesthetic.

Hospital attendance is minimised and optimal patients outcomes are maintained by streamlining processes and reducing duplication, investigation, assessment, unplanned cancellations and unexpected post-operative complications.

Key dates
Dec 2015
Dec 2018
Implementation sites
Sunshine Coast University Hospital


The framework aims to streamline processes and reduce duplication, investigation, assessment, unplanned cancellations, unexpected post-operative complications and minimise hospital attendance whilst maintaining optimal patient outcomes.


Effective assessment, and optimisation of patients undergoing procedures requiring an anaesthetic


The absence of standardised processes for pre-anaesthetic evaluation in Queensland has led to variance in practice and facilities developing their own processes for the delivery of pre-anaesthetic evaluation. In some centres all patients were seen by an anaesthetist pre-procedure resulting in costly over servicing and significant inconvenience to patients.

Solutions Implemented

The framework is designed with a patient focus and facilitates the involvement of patients in decision making about the care they receive. The framework aligns with the Queensland Government strategic objectives for healthcare – Department of Health strategic plan 2014-2018 and standards 1,2,4,6,7 of the National Safety and Quality Health Service Standards.

Evaluation and Results

The framework was published on the Queensland Health intranet site in October 2017 and the internet site in January 2018.  An Expression of Interest has been distributed to hospital and health services across Queensland aimed at commencing hospital based trials in February 2018.

Lessons Learnt

Effective, planned, organised preparation results in the delivery of safe, high quality healthcare, improved theatre efficiency and positive patient experiences.


Committee on S, Practice P, Apfelbaum JL, Connis RT, Nickinovich DG, American Society of Anesthesiologists Task Force on Preanesthesia E, et al. Practice advisory for preanesthesia evaluation: an updated report by the American Society of Anesthesiologists Task Force on Preanesthesia Evaluation. Anesthesiology. 2012;116(3):522-38.
Hines S, Munday J, Kynoch K. Effectiveness of nurse-led preoperative assessment services for elective surgery: a systematic review update. JBI Database System Rev Implement Rep. 2015;13(6):279-317.
Fischer SP. Development and effectiveness of an anesthesia preoperative evaluation clinic in a teaching hospital. The Journal of the American Society of Anesthesiologists. 1996;85(1):196-206.
Ireland S KB. Telephone pre-operative assessment for adults: reviewing the evidence through systematic review. ACORN; The Journal of Perioperative Nursing in Australia. 2013;26(4):23-9.
Hilditch WG, Asbury AJ, Crawford JM. Pre-operative screening: criteria for referring to anaesthetists. Anaesthesia. 2003;58(2):117-24.

Further Reading

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Key contact

Karen Hamilton
SWAPNet Coordinator
Healthcare Improvement Unit
(07) 3328 9164