Key result
PAC-Q electronic triage standardizes pediatric preanesthesia assessments, reducing unnecessary visits and improving screening uptake.
Why the study?
Does an electronic preanesthesia triage tool improve the completion rate of preanesthesia assessments in pediatric patients?
Observational (n=3,993)
Does an electronic preanesthesia triage tool improve the completion rate of preanesthesia assessments in pediatric patients?
Absolute Event Rate: 83.8% vs 71.3%
p-value: p=<0.0001
Implementation of a patient-administered electronic triage questionnaire significantly increased the completion rate of pediatric preanesthesia assessments.
May reduce unnecessary pediatric preanesthesia visits and improve screening; leaves open generalizability pending randomized validation across settings.
Background Preanesthesia assessment is essential but resource‐intensive. Electronic health records (EHRs) are widespread, yet pediatric perioperative screening remains variable. Objective To develop and implement a preanesthesia triage tool based on patient‐administered electronic triage questionnaire (PAC‐Q) integrated with the Epic EHR to streamline pediatric preanesthesia assessment. Methods Using a quality‐improvement framework, we created a preanesthesia triage tool that includes an adapted version of Epic's foundation questionnaire to form a 28‐item PAC‐Q distributed via MyChart. Responses were weighted (0, 1, or 100) to generate a triage score that, together with surgical risk, routed patients to an RN, NP, or MD for preanesthesia assessment. Implementation was staggered across surgical services. Adoption and outcomes were monitored via Epic dashboards and Power BI. Results By August 31, 2025, 3993 patients completed the PAC‐Q. Of these, 53.7% (2144/3993) were triaged to an RN, 12.3% (492/3993) to an NP, and 6.8% (272/3993) to an MD; 27.1% (1083/3993) were cleared by chart review without further consultation. Comparing April–June 2023 with April–June 2025, completed preanesthesia assessments increased from 71.3% (1182/1659) to 83.8% (1510/1802) ( χ 2 = 78.70, p < 0.0001). In otolaryngology, completion rose from 22.9% (65/284) to 82.7% (230/278) ( χ 2 = 199.37, p < 0.0001). Providers and families reported high satisfaction and reductions in administrative burden. Conclusions The PAC‐Q is a scalable, patient‐centered digital tool that standardizes pediatric preanesthesia triage, reduces unnecessary visits, and improves screening uptake. It can be adapted to diverse perioperative settings to enhance efficiency and patient experience.
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Mills et al. (2026) conducted an observational in Pediatric preanesthesia assessment (n=3,993). Patient-administered electronic triage questionnaire (PAC-Q) vs. Historical control (April-June 2023) was evaluated on Completed preanesthesia assessments (p=<0.0001). Implementation of a patient-administered electronic triage questionnaire increased completed pediatric preanesthesia assessments from 71.3% to 83.8% (p<0.0001).
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