Evaluation of utilisation and referral quality to an obstetric anaesthesia pre-assessment clinic
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Authors
Kamenou, Isabelle
Mohamed, Ayat
Dabrowicz, Adrian
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Issue Date
2026-05-14
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Abstract
Obstetric anaesthesia pre-assessment clinics (POACs) are essential for identifying and optimising maternity patients at increased anaesthetic risk, particularly those with obesity or complex comorbidities.
A retrospective service evaluation was conducted using EPIC electronic health records for all POAC referrals between January and June 2025 (6 months). Data were collated using Microsoft Forms and included referral source, referral documentation and indication, gestation at referral and attendance, clinic outcome, and documentation method. Clinic capacity and utilisation were analysed using scheduling data.
The project identified inefficient POAC utilisation due to inconsistent referrals and absence of triage system.
• In response, the clinic frequency was reduced from twice to once weekly to maintain capacity, while reducing service costs. The BMI referral criteria changed from BMI 40-45 kg/m2with co-morbidities and BMI over 45 kg/m2to patients with a BMI over 50 kg/m2and they will have face-to-face appointments now.
• Planned improvements include education of the referring clinicians, introduction of a formal triage system, refined referral criteria prioritising higher-risk patients, and mandatory documentation of referral indications.
• Re-evaluation is planned six months after implementation of changes.