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 A T Forrest, Carmel Kennedy

Research output: Contribution to journalArticleResearchpeer-review

Abstract

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
JournalCollegian
DOIs
Publication statusE-pub ahead of print - 13 May 2017
Externally publishedYes

Fingerprint

Patient Satisfaction
Length of Stay
Electronic Health Records
Practice Guidelines
Outcome Assessment (Health Care)
Incidence
Surveys and Questionnaires

Cite this

He, Jingjing ; Gallego, Blanca ; Stubbs, Christen ; Scott, Anne ; Dawson, Susan ; Forrest, Kirsty A T ; Kennedy, Carmel. / Improving patient flow and satisfaction : An evidence-based pre-admission clinic and transfer of care pathway for elective surgery patients. In: Collegian. 2017.
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abstract = "AimsTo redesign, implement and evaluate a Pre-Admission Clinic incorporated with a Transfer of Care Pathway for elective surgery patients.MethodsAn 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.ResultsA 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).ConclusionsThe 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.",
author = "Jingjing He and Blanca Gallego and Christen Stubbs and Anne Scott and Susan Dawson and Forrest, {Kirsty A T} and Carmel Kennedy",
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Improving patient flow and satisfaction : An evidence-based pre-admission clinic and transfer of care pathway for elective surgery patients. / He, Jingjing; Gallego, Blanca ; Stubbs, Christen; Scott, Anne; Dawson, Susan; Forrest, Kirsty A T; Kennedy, Carmel.

In: Collegian, 13.05.2017.

Research output: Contribution to journalArticleResearchpeer-review

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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 A T

AU - Kennedy, Carmel

PY - 2017/5/13

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N2 - AimsTo redesign, implement and evaluate a Pre-Admission Clinic incorporated with a Transfer of Care Pathway for elective surgery patients.MethodsAn 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.ResultsA 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).ConclusionsThe 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 - AimsTo redesign, implement and evaluate a Pre-Admission Clinic incorporated with a Transfer of Care Pathway for elective surgery patients.MethodsAn 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.ResultsA 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).ConclusionsThe 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.

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DO - 10.1016/j.colegn.2017.04.006

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