Streamlining elective surgery care in a public hospital: the Alfred experience.
Med J Aust
; 194(9): 448-51, 2011 May 02.
Article
em En
| MEDLINE
| ID: mdl-21534899
ABSTRACT
OBJECTIVE:
To evaluate the effectiveness of redesigning and streamlining perioperative services.DESIGN:
A before-and-after evaluation, with retrospective analysis of de-identified administrative data.SETTING:
A major tertiary hospital, Melbourne, Australia.PARTICIPANTS:
Patients undergoing elective surgery, February 2005 - February 2010. INTERVENTION Implementing a process redesign to streamline clinical pathways for elective surgery, with a focus on the patient journey from referral to discharge, and establishing a separate, dedicated elective surgery facility. MAIN OUTCOMEMEASURES:
Numbers of patients waiting beyond national recommended waiting times for elective surgery; hospital-initiated postponement (HIP) rates for elective surgery; and lengths of stay (LOS), both combined and for specific diagnostic-related groups.RESULTS:
The clinical process redesign resulted in a sustained downward trend in the number of elective surgery patients waiting longer than national recommended maximum waiting times. HIP rates were reduced to 1% in the dedicated elective surgery facility, and there was a significant reduction in the combined LOS, as well as the LOS for the most common surgical procedures (P < 0.001).CONCLUSIONS:
Clinical process redesign of perioperative services and collocation of a separate elective surgery centre improved (i) timeliness of care for elective surgery patients and (ii) key indicators (LOS and HIP rates) for planned elective admissions.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Admissão do Paciente
/
Listas de Espera
/
Procedimentos Cirúrgicos Eletivos
/
Assistência Perioperatória
/
Acessibilidade aos Serviços de Saúde
/
Hospitais Públicos
Tipo de estudo:
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
País/Região como assunto:
Oceania
Idioma:
En
Revista:
Med J Aust
Ano de publicação:
2011
Tipo de documento:
Article