Surgical Preoperative Risk Assessment & Optimization
Assess surgical risk and optimize preoperative patient outcomes
What You Can Do
You can rapidly synthesize complex patient data—comorbidities, functional status, labs, medications—into a comprehensive risk profile and actionable optimization plan. This skill guides you through ASA classification, procedure-specific risk stratification, and patient-centered consent documentation to ensure thorough clinical reasoning and defensible preoperative assessment.
Features
Assign appropriate American Society of Anesthesiologists risk level based on comorbidities and functional status
Identify risk factors tailored to the planned surgery type and complexity
Systematically evaluate impact of diabetes, cardiac disease, renal dysfunction, and other conditions on perioperative risk
Produce prioritized, evidence-based mitigation recommendations with realistic timelines
Generate structured preoperative notes that clearly document risk/benefit discussion and shared decision-making
Identify gaps in diagnostic workup and flag abnormalities requiring intervention before surgery
Review perioperative medication protocols including hold/continue decisions for high-risk drugs
Develop clear explanations of risks and optimization steps for patient counseling
Example Output
Risk Profile Summary:
- ASA Class III (controlled diabetes, hypertension, moderate deconditioning)
- Procedure Risk: Moderate (elective total knee arthroplasty)
- Primary Concerns: Glycemic control (HbA1c 8.2%), deconditioning
Optimization Plan:
- HbA1c Management — Target <8.0 before surgery; increase metformin monitoring; endocrinology consult if needed
- Cardiac Clearance — EKG shows no acute changes; stress test not indicated for ASA III patient undergoing orthopedic surgery
- Functional Optimization — Physical therapy 2–3×/week for 4 weeks; focus on lower-extremity strengthening
Preoperative Documentation Excerpt: Patient is a 68-year-old with well-controlled hypertension and diabetes presenting for elective TKA. Risks including infection, DVT, and anesthesia complications were discussed. Patient understands need for optimization and agrees with plan.
What's Included
- SKILL.md instruction file: Complete preoperative assessment workflow and clinical decision framework
- Preoperative Assessment Template: Structured note format for data collection and risk synthesis
- ASA Classification Checklist: Quick reference for assigning and justifying ASA level
- Comorbidity Risk Matrix: Procedure-specific risk factors organized by common surgical types
- Optimization Priority Worksheet: Tool for prioritizing interventions by impact and timeline
- Patient Counseling Script: Plain-language explanations of risks and optimization rationale
Who It's For
- Physician Assistants in surgery, orthopedics, and procedural specialties preparing patients for elective operations
- Surgical nurses and clinical coordinators building preoperative checklists and patient education materials
- Primary care physicians optimizing patients before referral to surgery
- Anesthesiologists and CRNAs conducting preoperative assessments and risk stratification
- Surgery residents and fellows developing structured assessment and documentation practices
Best For
- Preoperative risk stratification for patients with multiple comorbidities or complex medical histories
- Identifying reversible risk factors and building prioritized optimization plans with realistic timelines
- Generating defensible, thorough preoperative documentation that reflects shared decision-making
- Patient counseling and consent discussions explaining surgical risks and optimization rationale
- Coordinating multidisciplinary optimization (cardiology, endocrinology, physical therapy referrals)
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