St Elsewhere's or St Everywhere's: improving patient throughput in the private hospital sector

Communication errors have been found to be most common root cause of medical errors by the US-based Agency for Healthcare Research and Quality [1]. Although elective admissions to hospital involves a high volume of important healthcare communications where incorrect, missing or illegible information could result in a serious medical error, there is little published research on the impact of improving pre-admission communication flow between admitting doctors and hospitals. The Sydney Adventist Hospital (the San) is a 341-bed private hospital in Sydney's northern suburbs that provides a comprehensive range of health services. A process improvement program began in early 2005 to streamline preadmission communications. The objectives of this ongoing program are broadly to improve patient safety and to increase operating efficiency. The first major initiative within this program was to implement a standardised method for inpatient booking/referral with over three hundred admitting doctors. Eighteen months on, the hospital has been able to demonstrate a significant shift in the timeliness of patient bookings from specialists' rooms, more comprehensive provision of clinical indicators that can facilitate resource planning in operating theatres and on the wards, and reduction in the ratio of bookings made in areas other than the hospital bookings department. The program continues with focus on improving accuracy of data entry, rationalising patient forms, making more effective use of information received and automation of pre-admission information flows.