What does this research mean for the field?

A tiered perioperative optimization pathway focused on correcting modifiable risk factors is a more clinically meaningful model than traditional assessment clinics, effectively reframing the preoperative period as a treatment window. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.CHALLENGES_CONSENSUS.

What question did this study set out to answer?

To evaluate whether traditional preoperative clinics remain effective for perioperative safety and assess the evidence for shifting from administrative evaluation to active preoperative risk optimization.

September 5, 2026Current anesthesiology reportsOpen Access

Preoperative Clinics: Do We Still Need Them? Reframing the Preoperative Period as a Treatment Window

Q: What is the clinical evidence from this study?

Study design: Review. Population: Surgical patients. Intervention: Tiered perioperative optimization pathway vs. Traditional preoperative assessment clinics.

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Key result

Tiered perioperative optimization offers a more clinically meaningful model than traditional assessment clinics.

Why the study?

To examine whether traditional preoperative assessment clinics remain the appropriate model for perioperative care, and evaluate evidence for shifting from preoperative evaluation to preoperative optimization.

Does a tiered preoperative optimization pathway improve surgical outcomes compared to traditional preoperative assessment clinics in surgical patients?

Key Points

To evaluate whether traditional preoperative clinics remain effective for perioperative safety and assess the evidence for shifting from administrative evaluation to active preoperative risk optimization.
Reviewed clinical outcomes and health system architectures comparing traditional in-person assessment, virtual evaluation, and multi-tier preoperative screening pathways.
Evaluated modifiable risk factor domains, including anemia, hyperglycemia, impaired functional capacity, smoking cessation, delirium risk, and medication reconciliation.
Virtual preoperative evaluation is non-inferior to in-person assessment for preventing surgical cancellations and maintaining patient satisfaction, but screening alone achieves low optimization completion (e.g., 9.1% to 28% compliance) without structured follow-through.
Correction of preoperative modifiable risks improves surgical outcomes, with coordinated screening and follow-through programs reducing cancellations from 4.9% to 0.95%, hospital stay from 7.3 to 5.2 days, and postoperative complications from 32.7% to 19.6%.

Structured PICO

Does a tiered preoperative optimization pathway improve surgical outcomes compared to traditional preoperative assessment clinics in surgical patients?

Population

Surgical patients undergoing preoperative evaluation

Intervention

Tiered perioperative optimization pathway (universal virtual screening, modular specialist-led optimization, and anesthesiologist-coordinated planning for high-risk patients)

Comparator

Traditional in-person or virtual preoperative assessment clinics

Outcome

Perioperative complications, patient safety, and day-of-surgery cancellations

Shifting from traditional preoperative assessment to a structured, tiered preoperative optimization pathway allows clinicians to actively modify risk factors and improve surgical outcomes.

Limitations

Payment models do not reward the required investment in screening platforms and tracking systems.
Timing of optimization can conflict with surgical urgency, particularly in oncologic disease.
A virtual-first design risks excluding patients without reliable connectivity or digital literacy.
Administrative burden accrues from tracking interventions and outcomes.

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

Challenges traditional preoperative clinics; hypothesis-generating for tiered optimization pending randomized trials.

Cite This Study

Victor Davila (2026) conducted a review in Surgical patients. Tiered perioperative optimization pathway vs. Traditional preoperative assessment clinics was evaluated. A tiered perioperative optimization pathway combining universal virtual screening, modular optimization, and anesthesiologist coordination offers a more clinically meaningful model than traditional clinics.

synapsesocial.com/papers/6a9bd3e16b95aff0620eb0af https://doi.org/10.1007/s40140-026-00728-w

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Preoperative Clinics: Do We Still Need Them? Reframing the Preoperative Period as a Treatment Window

Key Points

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Preoperative Clinics: Do We Still Need Them? Reframing the Preoperative Period as a Treatment Window

Key Points

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

Also Consider