From: Patient experiences with interventions to reduce surgery cancellations: a qualitative study
Time periode | Clinical pathway before redesign | Clinical pathway after redesign |
---|---|---|
Consultation at outpatient clinic | Medical pre-assessment done the day before surgery. | Surgeons and anesthesia personnel did conjointly establish a new routine that clarified the responsibilities and division of labor between them. |
Patients cleared for surgery were sent home without an appointment for surgery and without a medical pre-assessment. | Patients participated in planning the date of surgery and obtained the actual appointment while at the outpatient clinic. | |
Consultation at drop-in anesthesia outpatient clinic at day-surgery center | Not applicable | A new day-surgery center established within existing premises. |
Patients cleared for surgery proceeded directly to the laboratory for blood tests and medical pre-assessment at newly established drop-in anesthesia outpatient clinic at the day-surgery center. | ||
Surgeon’s dictated notes written immediately after consultation for anesthesia personnel to have information at hand during preoperative assessment. | ||
Waiting for surgery | A letter with appointment for surgery was sent to the patient. Patients had no influence on appointment time. | Patients received a phone call from the hospital two days prior to surgery to ensure they were fit and ready. |
Limited planning across different surgical departments. Each department had their own surgery program that was not accessible on-line | One common electronic surgery planning system and the position of a coordinator for all surgical departments established. | |
Surgery | Patient showed up for pre-assessment the same day or one day in advance of the planned surgery. | All patients scheduled for elective surgery received at day-surgery center. |
Routines varied across departments. | Pre-surgery preparations standardized. | |
After surgery | Variation of discharge process in different department. | All day-surgery patients were discharged from the day-surgery center through new standardized routines. |
Discharge letter not always ready when the patient left. | Discharge letter written and given to the patient before discharge. |