By Maj. Elizabeth M. Bowles, WBAMC Same Day Surgery:
(El Paso, Texas, Feb. 1, 2018)
William Beaumont Army Medical Center has stepped up customer service and safety with telephonic preoperative nurse instruction for beneficiaries having surgeries and procedures at the hospital. This new process will not only save time, but will also decrease the risk for day-of-surgery cancellations and increase clinic productivity.
Previously, the process typically took 2 1/2 hours, and with limited waiting room space, it led to overcrowding (particularly when patients brought along family members). Previous processes did not guarantee the completion of required diagnostics available for anesthesia personnel to review, leading to day-of-surgery cancellations.
With telephonic preoperative instruction, surgical clinics place all orders when personnel see the patient. In addition, surgical clinics schedule a pre-operation instruction appointment for the patient, who receives a telephonic preoperative packet with a checklist. Patients then proceed to preregistration with the Patient Administration Department and complete electrocardiograms and diagnostics if needed.
Patients can now complete preoperative tasks on the same day personnel see them at their surgical clinic. Prior to the preoperative teaching appointment, a nurse will review the patient’s medical records and results and consult with an anesthesia provider to clear the patient for surgery and/or call the patient for more information, provide medication guidance or ask for a face-to-face visit. Ninety-five percent of patients are cleared and do not have to return to the hospital before their scheduled surgery.
There are four reasons patients may not participate in telephonic preoperative instruction: cognitive impairment, severe hearing impairment, required use of language line besides Spanish, and for cases involving children under 13 years of age who were born less than 37 weeks gestation. The SDS Clinic is in the process of installing three-way calling lines that will eliminate the use of the language line as a discriminator for telephonic preoperative instructions.
Jeanine Knox, telephonic preoperative clinical lead and preoperative registered nurse, worked with each clinic staff member to develop individualized plans which meet the needs of that particular surgical demographic. Knox further developed a patient survey that resulted in a 99 percent satisfaction rate from more than 1,300 patients. The process also streamlined, standardized and improved communication between SDS and surgical clinics, leading to a more pleasant patient-centered experience.
The new program provides patients more focused attention, safer preoperative screenings, less time waiting and more preoperative appointments, all while improving patient care by ensuring personnel meet higher safety standards, saving patients time and preventing workflow delays.
WBAMC staff and the committee developed for this project are currently sharing the processes they developed with the U.S. Army Medical Command as a best practice for standardized, efficient, effective and safe patient care for operative services.