TY - JOUR
T1 - Improving patient flow and satisfaction
T2 - an evidence-based pre-admission clinic and transfer of care pathway for elective surgery patients
AU - He, Jingjing
AU - Gallego, Blanca
AU - Stubbs, Christen
AU - Scott, Anne
AU - Dawson, Susan
AU - Forrest, Kirsty
AU - Kennedy, Carmel
PY - 2018/4
Y1 - 2018/4
N2 - 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.
AB - 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.
KW - Discharge planning
KW - Length of stay
KW - Patient satisfaction
KW - Pre-admission clinic
KW - Surgery cancellations
UR - http://www.scopus.com/inward/record.url?scp=85018919120&partnerID=8YFLogxK
U2 - 10.1016/j.colegn.2017.04.006
DO - 10.1016/j.colegn.2017.04.006
M3 - Article
AN - SCOPUS:85018919120
SN - 1322-7696
VL - 25
SP - 149
EP - 156
JO - Collegian
JF - Collegian
IS - 2
ER -