Patient flow in the preoperative assessment clinic.
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.
Edward
G M
GM
University of Amsterdam, Academic Medical Centre, Department of Anaesthesiology, Leiden, The Netherlands.
Razzaq
S
S
de Roode
A
A
Boer
F
F
Hollmann
M W
MW
Dzoljic
M
M
Lemaire
L C
LC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001071:Appointments and Schedules; D002648:Child; D002675:Child, Preschool; D017598:Efficiency, Organizational; D006305:Health Status Indicators; D006785:Hospitals, University / Q000458:organization & administration / Q000592:standards; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D009426:Netherlands; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration* / Q000592:standards; D011300:Preoperative Care / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000458:organization & administration; D012307:Risk Factors; D013997:Time Factors