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Anaesthetists should be involved in audit cycles, preferably using a ‘rapid-cycle’ quality improvement approach. These benchmark standards of care, and may be an effective change driver.  This approach is an excellent way of providing evidence of good practice as defined by the GMC, and mapping the contribution that individuals make to any service within their hospitals.^{58,128,129,211}

In recent years there has been a trend towards assessment of elective patients in preadmission clinics, typically one to two weeks before surgery. This allows routine paperwork and investigations to be completed before admission, permits ‘same day’ admission and reduces the likelihood of delays or cancellation.^48,49,50,51 Anaesthetists should be part of the preadmission clinical...

Regular audits of the following aspects of preoperative care may include:

• the effectiveness of preoperative information provided to patients
• preoperative documentation of consultation by anaesthetists
• consent to anaesthesia
• the effectiveness of preoperative assessment services
• preoperative visiting (patient waiting time, proportion of one stop visits)
• preoperative airway assessment
• preoperative fasting in adults and children
• appropriate preoperative medication
• thromboprophylaxis
• choice of technique...

Agreed local clinical guidelines should be in use, produced by an appropriately constituted multiprofessional team, comprising anaesthetists, specialist nurses, surgeons, critical care clinicians, pharmacists, specialty consultants and managers. These guidelines should cover at least the following:

• airway management, including follow up for difficult patients (both plastic surgery and burn reconstructive surgery)⁵⁹
• monitoring of free flaps³⁹
• monitoring of local...

In recent years there has been a trend towards assessment of elective patients in preadmission clinics, typically one to two weeks before surgery. This allows routine paperwork and investigations to be completed before admission, permits ‘same day’ admission and reduces the likelihood of delays or cancellation.⁵⁷ Anaesthetists should be part of the preadmission clinical pathway, including implementing interventions to...

Anaesthetists should be familiar with the specific needs of patients with cancer, including the following:

• the adverse effects of high concentrations of oxygen in the presence of some antineoplastic agents, for example Bleomycin, and adjust their technique accordingly.^51,52 Recent evidence confirms the association between unnecessarily high intraoperative FiO₂ and increased risk of major respiratory complications and...