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Patient flow in the preoperative assessment clinic

Published online by Cambridge University Press:  01 April 2008

G. M. Edward ,
S. Razzaq ,
A. de Roode ,
F. Boer ,
M. W. Hollmann ,
M. Dzoljic  and
L. C. Lemaire
G. M. Edward
Affiliation:
University of Amsterdam, Academic Medical Centre, Department of Anaesthesiology, Leiden, The Netherlands
S. Razzaq
Affiliation:
University of Amsterdam, Academic Medical Centre, Department of Medical Health Informatics, Amsterdam, Leiden, The Netherlands
A. de Roode
Affiliation:
University of Amsterdam, Academic Medical Centre, Leiden University, Leiden University Medical Centre, Department of Anaesthesiology, Leiden, The Netherlands
F. Boer
Affiliation:
University of Amsterdam, Academic Medical Centre, Leiden University, Leiden University Medical Centre, Department of Anaesthesiology, Leiden, The Netherlands
M. W. Hollmann*
Affiliation:
University of Amsterdam, Academic Medical Centre, Department of Anaesthesiology, Leiden, The Netherlands
M. Dzoljic
Affiliation:
University of Amsterdam, Academic Medical Centre, Department of Anaesthesiology, Leiden, The Netherlands
L. C. Lemaire
Affiliation:
University of Amsterdam, Academic Medical Centre, Department of Anaesthesiology, Leiden, The Netherlands
*
Markus W. Hollmann, Department of Anaesthesiology, Academic Medical Centre, University of Amsterdam, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands. E-mail: [email protected]; Tel: +31 20 5663630; Fax: +31 20 6979441
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Summary

Background and objective

Previous research has shown that a preoperative assessment clinic enhances hospital cost-efficiency. However, the differences in organization of the patient flow have not been analysed. In this descriptive study, we evaluated the consequences of the organization of the patient flow of a preoperative assessment clinic on its performance, by analysing two Dutch university hospitals, which are organized essentially differently.

Methods

In the final analysis, the study included 880 patients who visited either academic centre. The performance of the two preoperative assessment clinics was evaluated by measuring patient flow time, various procedure times and the total waiting time. Patients’ age, ASA physical status and any preoperative tests requested by the physician were also recorded.

Results

There was a significant difference in patient flow time between the two preoperative assessment clinics. More time was needed for the preoperative assessment when patients’ ASA class was higher. The patient flow time was longer when electrocardiogram and venepuncture were performed at the general outpatient laboratory than when they were performed at the preoperative assessment clinic due to longer waiting times. More tests were requested when they were performed at the preoperative assessment clinic.

Conclusions

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.

Keywords

ORGANIZATION AND ADMINISTRATIONAMBULATORY CAREPREOPERATIVE CAREANAESTHESIOLOGY
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 25 , Issue 4 , April 2008 , pp. 280 - 286
Copyright
Copyright © European Society of Anaesthesiology 2008

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