Preoperative assessment plays a vital role in all surgeries that are to be performed under general anesthesia. It helps in the preparation of the patient and optimization of risk factors before surgery, involvement of multidisciplinary teams to avoid complications, decrease length of stay, and reduce the delays in surgery. The aim of this quality research work was to improve preoperative anesthesia assessment compliances of patients undergoing elective orthopedic surgeries. A retrospective review of data was conducted for orthopedic services in a tertiary care hospital for a period from January to June 2017 of all patients planned for elective surgeries. The data analysis showed only 31% compliances. In order to enhance these compliances, a preoperative nurse was hired in the service and she functioned closely with the surgeons. After interventions, the preoperative compliances increased from 31 to 81% in the next three months from July to September 2017. The targeted benchmark to achieve maximum compliances is up to 95 to 100%. Preoperative optimization not only benefits in early recognition of risk factors, but it also contributes towards positive clinical outcomes of patients after surgery. Moreover, it promotes speedy recovery and decreases the length of hospital stay.