title: Improving efficiency and patient satisfaction in a tertiary teaching hospital preoperative clinic.
abstract: BACKGROUND
  Clinical and organizational aspects of the preoperative visit can have a significant impact on patient satisfaction. The authors' previous work demonstrated that communication of information from the clinician to the patient was found to be the most positively rated component, whereas organizational issues, particularly waiting time, were the most negative. This study compares two yearly cycles of patient satisfaction surveys to assess the process and impact of implementation of changes.
  
  
  METHODS
  The authors distributed a one-page questionnaire, consisting of elements evaluating satisfaction with clinical providers and with organizational aspects of the visit, to patients in their preoperative clinic during two different time periods. Fourteen different questions had five Likert scale options ranging from excellent to poor. Changes implemented included clerical, scheduling, and clinical changes.
  
  
  RESULTS
  The overall collection rate of completed questionnaires was 79%. The scores for each question in Cycle 2 were higher for all questions, with 3 of 14 reaching statistical significance (P < 0.01). These questions related to the explanation of the Preoperative Assessment Clinic by the surgeon's office, courtesy and efficiency of the clinic staff, and satisfaction with waiting time. Average waiting time was reduced from 92 to 41 min (P < or = 0.0001).
  
  
  CONCLUSIONS
  Analysis of patient flow and clinic operations led to alterations in clinic processes. Alterations included education of clinic and surgical office staff to improve customer service, and implementation of changes in provider roles. These modifications resulted in an improvement in patient satisfaction and a reduction in waiting time with minimal economic impact.
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. dhepner@partners.org
authors.forename: Miriam J P
authors.initials: MJ
authors.lastname: Harnett
authors.forename: Darin J
authors.initials: DJ
authors.lastname: Correll
authors.forename: Shelley
authors.initials: S
authors.lastname: Hurwitz
authors.forename: Angela M
authors.initials: AM
authors.lastname: Bader
authors.forename: David L
authors.initials: DL
authors.lastname: Hepner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities; D001071:Appointments and Schedules; D017598:Efficiency, Organizational / Q000191:economics / Q000592:standards*; D005260:Female; D006784:Hospitals, Teaching / Q000191:economics / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners; D010044:Outpatient Clinics, Hospital; D017060:Patient Satisfaction; D011300:Preoperative Care / Q000191:economics / Q000592:standards*; D011785:Quality Assurance, Health Care; D011795:Surveys and Questionnaires; D055815:Young Adult