Presurgical Evaluation Case Study: Improving Presurgical Evaluation to Optimize the Daily Schedule
According to the Healthcare Cost and Utilization Project (HCUP) the total number of surgeries at community hospitals in the United States increased by 17% to about 26.8 million procedures in 2015. Is your hospital’s presurgical evaluation and screening process performing at an optimum level?
Discover how Sullivan Healthcare Consulting perioperative consultants implemented process improvements for a large community hospital struggling with unproductive preadmission testing and presurgical evaluations, and lengthy patient stays.
Identifying opportunities for improvement in preanesthesia testing (PAT) and presurgical screening (PSS), to ensure that patients were clinically ready for surgery
Hospital considered constructing a new PAT/PSS clinic
Wanted to ensure best practices were incorporated in design
How Our Perioperative Consultants Improved Presurgical Evaluations
Our perioperative consultants partnered with the hospital’s surgery governance committee to implement the following:
Reengineering the PAT process to ensure 100% of elective patients were properly screened and prepared for surgery
Establishing a cutoff time of noon the day prior to surgery for completion of elective case charts
Recommending the development of standard screening and testing criteria for the department of anesthesiology
Training RNs on the efficient use of a standardized phone screening tool
Establishing a daily multidisciplinary “huddle” to review patient readiness for surgery
Establishing a “stop-the-line” process if all elements were not in place by noon the day prior to scheduled surgery
Established a newly designed PSS version of the daily OR schedule indicating special patient conditions and readiness, which increased consistency and streamlined communication
Developed and implemented an anesthesia screening tool
Increased nursing efficiency by creating a standardized screening process
Reinforced and maintained the daily huddle
Put in place a procedure for the anesthesiologist in charge or an OR director to contact surgeons directly regarding cases that needed to be rescheduled due to incomplete patient information
Ongoing efforts using LEAN process improvement initiatives resulted in further improvements:
Changed the target time from noon to 11:00 AM so that by noon, virtually 100% of charts were completed
Created a “red folder” of patients who screened positive, with anesthesiology reviewing information daily during the huddle and managing cases according to patient need
Established a standard faxing location in PSS using RightFax so that all faxes could be electronically tracked
Ensured that all activities and improvements were compatible with the anticipated implementation of a new, computerized management system
Improved staff, surgeon, and anesthesiologist job satisfaction and utilized resources more efficiently
During implementation, our perioperative consultants provide hospital administration with a list of quantitative measurements that identify where they started, six-month goals, and long-term/final goals. Our team of experts can ensure that the implementation of recommendations will result in a more-than-adequate return on investment.
To learn more about our services and how Sullivan can help improve your organization’s performance, contact us today.
Randy Heiser is the President of Sullivan Healthcare Consulting. Randy has been a hospital consultant since 1983 and has specialized in perioperative consulting since 1992. He has directed more than 500 surgery department operational improvement studies (and participated in an additional 350) in programs ranging from small community hospitals and freestanding surgery centers to some of the largest university hospitals in the U.S. He was instrumental in the design, development and implementation of the Surgery Benchmark Program that has been used by more than 280 hospitals. He has also participated in the design of several proprietary surgery scheduling information systems currently available in North America.