Improving patient flow in pre-operative assessment.

Area of Science:

• Healthcare Management
• Quality Improvement in Healthcare
• Surgical Patient Care

Background:

• Pre-operative assessment departments face increasing patient attendances, leading to longer wait times and decreased patient satisfaction.
• Inefficiencies in patient flow, referral pathways, and staff roles contributed to suboptimal service delivery.
• Rising demand necessitated a review of operational processes to improve patient care and resource utilization.

Purpose of the Study:

• To implement a Lean quality improvement process to enhance efficiency in a pre-operative assessment department.
• To reduce patient lead times and improve the timeliness of pre-operative assessments relative to surgery dates.
• To address patient dissatisfaction stemming from long waits and capacity limitations.

Main Methods:

• A Lean quality improvement methodology utilizing Plan-Do-Study-Act (PDSA) cycles was employed.
• Standardized work for healthcare workers (HCWs) and nurses was developed, alongside 5S process implementation for room standardization.
• A coordinator role was introduced to manage patient flow and medical assessments, appointment scheduling was optimized, and referral pathways were consolidated.

Main Results:

• Average patient lead time decreased from 79 minutes to 59 minutes.
• The proportion of patients assessed within two weeks of surgery reduced from 9.3% to 5.3%.
• Referrals for anaesthetic opinions decreased from 30% to 20%, with no patients requiring return visits due to capacity issues.

Conclusions:

• Lean quality improvement effectively reduced patient lead times and improved the efficiency of pre-operative assessment services.
• Standardization of processes, roles, and environments significantly enhanced patient flow and reduced operational bottlenecks.
• The implemented changes led to improved patient experience and better resource allocation within the department.