title: Applying clinical process redesign methods to planned arrivals in New South Wales hospitals.
abstract: *Competing demands of planned and unplanned arrivals present major challenges for hospitals. *Applying clinical process redesign methods to the planned patient journey allows management to recognise the blocks and inefficiencies in the journey and facilitates the development of solutions for improvement. *Redesign of the planned patient journey in New South Wales has promoted the expansion of the extended day-only model of care, reformed the waiting times policy, standardised patient preadmission assessment and preparation, and targeted operating theatre use. *Improved performance management at Area Health Service and local facility levels has accompanied the redesign of planned arrival processes. *The results in redesign of surgery undertaken by the Area Health Services in 96 NSW hospitals have been impressive, with results within 2 years of commencing the clinical services redesign program showing: a 97% reduction in the numbers of patients in Category 1 (admission desirable within 30 days) whose surgery was overdue, from 5308 in January 2005 to 135 in June 2007; and a 99% reduction in the number of patients who have waited > 365 days for surgery, from 10 551 in January 2005 to 84 in June 2007. *Improved surgical service efficiency, safety and quality justify the continuation of the redesign program.
authors.affiliation: Health Services Performance Improvement, NSW Health, Sydney, NSW, Australia.
authors.forename: Donald G
authors.initials: DG
authors.lastname: MacLellan
authors.forename: Patrick C
authors.initials: PC
authors.lastname: Cregan
authors.forename: Brian C
authors.initials: BC
authors.lastname: McCaughan
authors.forename: Tony J
authors.initials: TJ
authors.lastname: O'Connell
authors.forename: Katherine M
authors.initials: KM
authors.lastname: McGrath
mesh_terms: D001071:Appointments and Schedules; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006779:Hospitals, Public / Q000458:organization & administration; D006801:Humans; D009313:National Health Programs / Q000458:organization & administration; D009517:New South Wales; D009873:Operating Rooms / Q000706:statistics & numerical data; D009936:Organizational Innovation; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team / Q000458:organization & administration* / Q000706:statistics & numerical data; D010359:Patient Readmission; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data*; D014850:Waiting Lists