Preoperative evaluation for non-cardiac elective surgery can often be disjointed. It’s inefficient and costly for all when providers order preoperative tests that are not indicated. At the same time, Operating Room time and money is wasted when necessary preoperative tests are not completed. The Carolinas Established Surgical Preoperative Algorithm - CeSPA - gives providers a powerful tool to inform care decisions.

Thoroughly and systematically determining a patient’s preoperative health status can significantly improve preoperative care and postoperative outcomes. CeSPA uses the most recent evidence-based practice guidelines to guide providers on which preoperative tests for non-cardiac elective surgery patients are indicated - or not indicated. CeSPA standardizes preoperative evaluation to ensure that every patient receives the best evidence-based care. CeSPA guides patients and providers through a series of questions related to:

•Patient Characteristics
•Recent Signs and Symptoms
•Recent Testing Procedures
•Functional Limitations
•Medications
•Graded Risk of Surgery
•Surgery Characteristics

Based on these answers, CeSPA calculates which standard preoperative tests are indicated, and the level of evidence for each. The provider can access documentation supporting the recommendations. The provider can then email a summary PDF of the all recommendations and the APP Questions and Answers, so that the CeSPA results can be included in the patient’s electronic health record. To ensure privacy, a unique patient ID is generated and no personally identifiable information is included.

Our ultimate goal is to give providers a user-friendly and accessible solution to ensure patients receive evidence-based preoperative evaluation.