Scope and Target Population:
The guideline describes appropriate evaluation for elective, non-high-risk operative procedures for adult and pediatric patients. Pediatric patients for whom this guideline is intended are those between the ages of 2 and 15 years. Patients over age 15 are considered adults for the purposes of this guideline.

Clinical Highlights and Recommendations

• Provide a comprehensive preoperative basic health assessment for all patients undergoing a diagnostic or therapeutic procedure as defined in the guideline.
  
• Most laboratory and diagnostic tests including electrocardiograms are not necessary with routine procedures unless a specific indication is present.
  
• Patient education and instruction strongly influence perioperative outcomes (e.g., insulin, anticoagulants, and beta-blocker management, apnea screening and surgical site infection).

Priority Aims

1. Increase the percentage of complete preoperative history and physical examinations obtained for patients two years of age and older undergoing elective, non-high-risk surgery and eliminate diagnostic tests performed without clinical indications.
   
2. Increase the percentage of patients two years of age and older undergoing elective, non-high-risk surgery who receive appropriate management of stable comorbidities prior to procedure.
   
3. Eliminate canceled or delayed elective, non-high-risk surgical procedures for patients two years of age and older due to incomplete preoperative history and physical examinations and communication.

Additional Background:
Most non-high-risk patients having elective surgery do not require routine laboratory and diagnostic testing including electrocardiograms unless a specific indication is present. This guideline acknowledges this observation and stresses a basic history and physical examination as the key events in a preoperative assessment. Further testing is required for certain procedures, abnormal findings and age-related risks.