Anesthesia preoperative evaluation clinic (APEC) restructuring plan for improving the quality of surgical patient flow

Detalhes bibliográficos
Autor(a) principal: Alboim, Carolina
Data de Publicação: 2018
Outros Autores: Teixeira, Alice Becker, Soares, Luciana Eltz, Machado, Vanda Regina, Stefani, Luciana Cadore
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Clinical and Biomedical Research
Texto Completo: https://seer.ufrgs.br/index.php/hcpa/article/view/82912
Resumo: Introduction: Anesthesia preoperative evaluation clinics (APECs) are useful for high-risk surgical patient care, as they improve perioperative outcomes and optimize patient care flow. At Hospital de Clínicas de Porto Alegre, APEC assesses 20% of all patients undergoing surgery, showing the importance of implementing strategies to improve outpatient clinic efficiency by prioritizing high-risk patients.Methods: Using a specific quality management tool for process improvement (PDCA, which stands for Plan/Do/Check/Act), new protocols were developed for patient referral and preoperative evaluation. Clinical staff was trained in the new routines, and an electronic screening system for patient referral was adopted. Data on patient profiles, referring surgical specialties, type of surgery, and waiting times for appointment and surgical procedure were compared before and after the intervention.Results: APEC performed 1,286 appointments between 2013 and 2016, including 733 pre-intervention and 553 post-intervention. There was a significant decrease in the appointments for patients undergoing minor surgery and an increase in the appointments for those undergoing major surgery.  The waiting time between referral to APEC and first APEC appointment reduced from 46 to 16 days. In addition, there was an increase in vascular, orthopedic, and urology referrals, as well as a reduction in ophthalmology and general surgery referrals. Conclusion: The PDCA method assisted with conceiving, executing, and monitoring the implemented strategies for changing the profile of patients evaluated at APEC.  The major challenge is to measure the long-term impact of this intervention and expand care through specific strategies for surgical specialties and procedures. KEYWORDS: Preanesthesia evaluation; preoperative evaluation; preoperative stratification; risk stratification
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spelling Anesthesia preoperative evaluation clinic (APEC) restructuring plan for improving the quality of surgical patient flowAnesthesia preoperative evaluation clinic (APEC) restructuring plan for improving the quality of surgical patient flowPreanesthesia evaluationpreoperative evaluationpreoperative stratificationrisk stratificationPreanesthesia evaluationpreoperative evaluationpreoperative stratificationrisk stratificationAnesthesiaIntroduction: Anesthesia preoperative evaluation clinics (APECs) are useful for high-risk surgical patient care, as they improve perioperative outcomes and optimize patient care flow. At Hospital de Clínicas de Porto Alegre, APEC assesses 20% of all patients undergoing surgery, showing the importance of implementing strategies to improve outpatient clinic efficiency by prioritizing high-risk patients.Methods: Using a specific quality management tool for process improvement (PDCA, which stands for Plan/Do/Check/Act), new protocols were developed for patient referral and preoperative evaluation. Clinical staff was trained in the new routines, and an electronic screening system for patient referral was adopted. Data on patient profiles, referring surgical specialties, type of surgery, and waiting times for appointment and surgical procedure were compared before and after the intervention.Results: APEC performed 1,286 appointments between 2013 and 2016, including 733 pre-intervention and 553 post-intervention. There was a significant decrease in the appointments for patients undergoing minor surgery and an increase in the appointments for those undergoing major surgery.  The waiting time between referral to APEC and first APEC appointment reduced from 46 to 16 days. In addition, there was an increase in vascular, orthopedic, and urology referrals, as well as a reduction in ophthalmology and general surgery referrals. Conclusion: The PDCA method assisted with conceiving, executing, and monitoring the implemented strategies for changing the profile of patients evaluated at APEC.  The major challenge is to measure the long-term impact of this intervention and expand care through specific strategies for surgical specialties and procedures. KEYWORDS: Preanesthesia evaluation; preoperative evaluation; preoperative stratification; risk stratification Introduction: Anesthesia preoperative evaluation clinics (APECs) are useful for high-risk surgical patient care, as they improve perioperative outcomes and optimize patient care flow. At Hospital de Clínicas de Porto Alegre, APEC assesses 20% of all patients undergoing surgery, showing the importance of implementing strategies to improve outpatient clinic efficiency by prioritizing high-risk patients. Methods: Using a specific quality management tool for process improvement (PDCA, which stands for Plan/Do/Check/Act), new protocols were developed for patient referral and preoperative evaluation. Clinical staff was trained in the new routines, and an electronic screening system for patient referral was adopted. Data on patient profiles, referring surgical specialties, type of surgery, and waiting times for appointment and surgical procedure were compared before and after the intervention. Results: APEC performed 1,286 appointments between 2013 and 2016, including 733 pre-intervention and 553 post-intervention. There was a significant decrease in the appointments for patients undergoing minor surgery and an increase in the appointments for those undergoing major surgery.  The waiting time between referral to APEC and first APEC appointment reduced from 46 to 16 days. In addition, there was an increase in vascular, orthopedic, and urology referrals, as well as a reduction in ophthalmology and general surgery referrals.  Conclusion: The PDCA method assisted with conceiving, executing, and monitoring the implemented strategies for changing the profile of patients evaluated at APEC.  The major challenge is to measure the long-term impact of this intervention and expand care through specific strategies for surgical specialties and procedures. KEYWORDS: Preanesthesia evaluation; preoperative evaluation; preoperative stratification; risk stratification HCPA/FAMED/UFRGS2018-11-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionPeer-reviewed ArticleAvaliado por Paresapplication/pdfhttps://seer.ufrgs.br/index.php/hcpa/article/view/82912Clinical & Biomedical Research; Vol. 38 No. 3 (2018): Clinical and Biomedical ResearchClinical and Biomedical Research; v. 38 n. 3 (2018): Clinical and Biomedical Research2357-9730reponame:Clinical and Biomedical Researchinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSenghttps://seer.ufrgs.br/index.php/hcpa/article/view/82912/pdfCopyright (c) 2018 Clinical and Biomedical Researchinfo:eu-repo/semantics/openAccessAlboim, CarolinaTeixeira, Alice BeckerSoares, Luciana EltzMachado, Vanda ReginaStefani, Luciana Cadore2024-01-19T14:22:48Zoai:seer.ufrgs.br:article/82912Revistahttps://www.seer.ufrgs.br/index.php/hcpaPUBhttps://seer.ufrgs.br/index.php/hcpa/oai||cbr@hcpa.edu.br2357-97302357-9730opendoar:2024-01-19T14:22:48Clinical and Biomedical Research - Universidade Federal do Rio Grande do Sul (UFRGS)false
dc.title.none.fl_str_mv Anesthesia preoperative evaluation clinic (APEC) restructuring plan for improving the quality of surgical patient flow
Anesthesia preoperative evaluation clinic (APEC) restructuring plan for improving the quality of surgical patient flow
title Anesthesia preoperative evaluation clinic (APEC) restructuring plan for improving the quality of surgical patient flow
spellingShingle Anesthesia preoperative evaluation clinic (APEC) restructuring plan for improving the quality of surgical patient flow
Alboim, Carolina
Preanesthesia evaluation
preoperative evaluation
preoperative stratification
risk stratification
Preanesthesia evaluation
preoperative evaluation
preoperative stratification
risk stratification
Anesthesia
title_short Anesthesia preoperative evaluation clinic (APEC) restructuring plan for improving the quality of surgical patient flow
title_full Anesthesia preoperative evaluation clinic (APEC) restructuring plan for improving the quality of surgical patient flow
title_fullStr Anesthesia preoperative evaluation clinic (APEC) restructuring plan for improving the quality of surgical patient flow
title_full_unstemmed Anesthesia preoperative evaluation clinic (APEC) restructuring plan for improving the quality of surgical patient flow
title_sort Anesthesia preoperative evaluation clinic (APEC) restructuring plan for improving the quality of surgical patient flow
author Alboim, Carolina
author_facet Alboim, Carolina
Teixeira, Alice Becker
Soares, Luciana Eltz
Machado, Vanda Regina
Stefani, Luciana Cadore
author_role author
author2 Teixeira, Alice Becker
Soares, Luciana Eltz
Machado, Vanda Regina
Stefani, Luciana Cadore
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Alboim, Carolina
Teixeira, Alice Becker
Soares, Luciana Eltz
Machado, Vanda Regina
Stefani, Luciana Cadore
dc.subject.por.fl_str_mv Preanesthesia evaluation
preoperative evaluation
preoperative stratification
risk stratification
Preanesthesia evaluation
preoperative evaluation
preoperative stratification
risk stratification
Anesthesia
topic Preanesthesia evaluation
preoperative evaluation
preoperative stratification
risk stratification
Preanesthesia evaluation
preoperative evaluation
preoperative stratification
risk stratification
Anesthesia
description Introduction: Anesthesia preoperative evaluation clinics (APECs) are useful for high-risk surgical patient care, as they improve perioperative outcomes and optimize patient care flow. At Hospital de Clínicas de Porto Alegre, APEC assesses 20% of all patients undergoing surgery, showing the importance of implementing strategies to improve outpatient clinic efficiency by prioritizing high-risk patients.Methods: Using a specific quality management tool for process improvement (PDCA, which stands for Plan/Do/Check/Act), new protocols were developed for patient referral and preoperative evaluation. Clinical staff was trained in the new routines, and an electronic screening system for patient referral was adopted. Data on patient profiles, referring surgical specialties, type of surgery, and waiting times for appointment and surgical procedure were compared before and after the intervention.Results: APEC performed 1,286 appointments between 2013 and 2016, including 733 pre-intervention and 553 post-intervention. There was a significant decrease in the appointments for patients undergoing minor surgery and an increase in the appointments for those undergoing major surgery.  The waiting time between referral to APEC and first APEC appointment reduced from 46 to 16 days. In addition, there was an increase in vascular, orthopedic, and urology referrals, as well as a reduction in ophthalmology and general surgery referrals. Conclusion: The PDCA method assisted with conceiving, executing, and monitoring the implemented strategies for changing the profile of patients evaluated at APEC.  The major challenge is to measure the long-term impact of this intervention and expand care through specific strategies for surgical specialties and procedures. KEYWORDS: Preanesthesia evaluation; preoperative evaluation; preoperative stratification; risk stratification
publishDate 2018
dc.date.none.fl_str_mv 2018-11-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
Peer-reviewed Article
Avaliado por Pares
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://seer.ufrgs.br/index.php/hcpa/article/view/82912
url https://seer.ufrgs.br/index.php/hcpa/article/view/82912
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv https://seer.ufrgs.br/index.php/hcpa/article/view/82912/pdf
dc.rights.driver.fl_str_mv Copyright (c) 2018 Clinical and Biomedical Research
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2018 Clinical and Biomedical Research
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv HCPA/FAMED/UFRGS
publisher.none.fl_str_mv HCPA/FAMED/UFRGS
dc.source.none.fl_str_mv Clinical & Biomedical Research; Vol. 38 No. 3 (2018): Clinical and Biomedical Research
Clinical and Biomedical Research; v. 38 n. 3 (2018): Clinical and Biomedical Research
2357-9730
reponame:Clinical and Biomedical Research
instname:Universidade Federal do Rio Grande do Sul (UFRGS)
instacron:UFRGS
instname_str Universidade Federal do Rio Grande do Sul (UFRGS)
instacron_str UFRGS
institution UFRGS
reponame_str Clinical and Biomedical Research
collection Clinical and Biomedical Research
repository.name.fl_str_mv Clinical and Biomedical Research - Universidade Federal do Rio Grande do Sul (UFRGS)
repository.mail.fl_str_mv ||cbr@hcpa.edu.br
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