Improving patient flow and satisfaction

an evidence-based pre-admission clinic and transfer of care pathway for elective surgery patients

Jingjing He*, Blanca Gallego, Christen Stubbs, Anne Scott, Susan Dawson, Kirsty Forrest, Carmel Kennedy

*Corresponding author for this work

Research output: Contribution to journalArticle


Aims: To redesign, implement and evaluate a Pre-Admission Clinic incorporated with a Transfer of Care Pathway for elective surgery patients. Methods: An evidence-based approach was used to redesign the Pre-Admission Clinic and the Transfer of Care Pathway. The impact of the pre-admission clinic and the care pathway was evaluated. De-identified data containing patient outcomes was collected from the hospital electronic medical record system from May 2014 to March 2015. Outcome measures included surgical cancellations, last-minute cancellations, average length of stay, discharge delays, and adverse events that were compared pre and post-implementation. Patient satisfaction was measured pre and post-implementation by using a modified version of Best Practice hospital survey. Results: A total of 10,854 eligible cases were included (5716 in the pre-implementation period and 5138 in the post-implementation period). The overall cancellation rate remained relatively stable (p = 0.95), however, the last-minute cancellation rate was reduced post-implementation (p = 0.02). Although no difference was observed in average length of stay (p = 0.39), the percentage of discharge delays was reduced (p = 0.027). The incidence of adverse events was too low to draw statistical conclusion. A sample of 102 patients completed the patient satisfaction survey. The overall satisfaction improved post-implementation (p = 0.03). Conclusions: The evidence-based Pre-Admission Clinic and the Transfer of Care Pathway had a positive impact on last-minute surgical cancellations, discharge delays and patient satisfaction.

Original languageEnglish
Pages (from-to)149-156
Number of pages8
Issue number2
Publication statusPublished - Apr 2018


  • Discharge planning
  • Length of stay
  • Patient satisfaction
  • Pre-admission clinic
  • Surgery cancellations

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