Patient flow in the preoperative assessment clinic

Abstract

This study shows that the organization of patient flow is an important aspect of the logistic processes of the preoperative assessment clinic. It might influence patient flow times as well as the number of preoperative tests requested. Together with other aspects of logistic performance, patient satisfaction and quality of medical assessment, patient flow logistics can be used to assess the quality of a preoperative assessment clinic.

Building a Better Preoperative Assessment Clinic

“…8,9 Also the quality of PACs can be assessed through examining logistic performance, quality of medical evaluation, patient satisfaction, and patient flow, as it relates to efficient organization and the need for preoperative testing. 10 From a patient's perspective of health care, quality is not only determined by the outcome of treatment but also by the extent to which patients are supported. 11 Preoperative anesthetic assessments provide the opportunity for patients to gain knowledge, develop trusting relationships with health care providers, decrease anxieties, and improve satisfaction.…”

Curing the queue

“…This increases the complexity of the PAC organization as compared with a regular outpatient clinic. In our PAC at Leiden University Medical Center, patient waiting times and LOS (in this case the total duration of one clinic visit) were initially significantly shorter than in a comparable clinic [64], but these increased dramatically after introduction of an electronic patient data management system, since together with the information system additional administrative activities were introduced. Also, the workload of the staff increased, leading to multiple complaints about work stress.…”

“…However, the literature on re-design of outpatient and preanesthesia evaluation clinics is limited. Some studies are dedicated to the design of appointment systems [55], others concentrated largely on waiting times and patient satisfaction [64,92]. The concept of re-design by reallocating tasks at the outpatient clinic has received less attention.…”

“…Dexter [55] states that the best service walk-in PACs can provide will always be worse than appointment PACs. The walk-in PAC requires more resources to have acceptable waiting times for patients [64], since more slack is required to deal with unexpected peaks in patient arrival. Appointment systems on the other hand deal with peaks in demand for PAC services by building waiting lists.…”

“…Since then, simulation has been used extensively for the study of outpatient clinics. Within the scope of the PAC, simulation was used to analyze the capacity needed to shorten the waiting list [64] and to study the design of appointment systems for the PAC to minimize patient waiting times [55].…”