# Pre-admission clinic

> A pre-admission clinic assesses patients before elective surgery to identify and optimise anaesthetic risk. Its persistent problem is allocation rather than capability — clinics are commonly booked out for weeks with low-risk patients while high-risk patients receive a phone call, because slots are filled in booking order rather than by screened risk.

*Source: https://getpathways.ai/glossary/pre-admission-clinic*

Also known as: PAC, pre-anaesthetic clinic, pre-operative assessment clinic

- **Also called**: PAC, pre-anaesthetic clinic
- **Purpose**: Identify and optimise anaesthetic risk before elective surgery
- **Common bottleneck**: Slots allocated by availability rather than by risk
- **Typical staffing**: Clinical nurse consultants with anaesthetist review

## The allocation problem

Most pre-admission clinics are not short of clinical capability. They are short
of a mechanism for deciding who should be in them. Without one, appointments are
allocated in the order bookings arrive, which produces a clinic full of healthy
ASA 1 and 2 patients who need nothing, and a frail patient with poor functional
capacity who gets a fifteen-minute phone call because the diary was full.

The consequence is felt in two places at once: theatre loses cases to problems
that a clinic visit would have caught, and clinic time is consumed by patients
for whom the visit changes nothing.

## What changes with risk-based routing

If every booked patient is screened at the point of booking, the queue becomes
orderable. Red-tier profiles go to anaesthetist review, moderate-tier profiles
take the clinic slots, low-risk patients proceed without an appointment, and the
remainder are handled by telephone. The clinic's capacity does not change — its
allocation does.