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Four-step problem solving improves surgical patient experience

24 Jun 2018

Schedule uncertainty drops dramatically



By: Deni Hoover, Surgical Services vice president

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Our busy surgery schedule here at Salem Health means that we make adjustments for safety and efficiency right up until the afternoon before surgery. This allows maximum flexibility to respond to patient needs – but also that patients did not receive a call with their arrival time for surgery until the afternoon or evening prior to their surgery.

As you can imagine, this uncertainty is hard on our patients. It also caused confusion and re-work, as patients would call their physician’s office or other parts of the hospital trying to determine their scheduled time. Our practice created anxiety and frustration for our patients.

A group of brave problem solvers started tackling this problem through our 4SPS process last October. Today, I’m proud to share our rate has gone from none of our patients being notified of their schedule 24 hours in advance … to 85 percent.

The team included representatives from access services, prep & recovery, surgical scheduling, and anesthesia. The problem was defined by acknowledging that we did not tell our patients their arrival time 24 hours in advance, which had a real impact on their readiness and confidence before surgery.

The team started by simulating different ways we could notify patients, then trying the new process, with some check and adjust opportunities. The ability to flex and change the surgical schedule was maintained by recalling patients whose surgeries were booked the day prior or whose procedures had been moved up or down the schedule by more than 30 minutes.

We’ve had good feedback from patients who appreciate being able to arrange a ride or for their family to come with them. The process continues to be refined to reduce waste and serve the patient.

Thanks to the following team members for this amazing result: Matt Boles, MD (anesthesia); Kristen Myers, RN (admin); Kelly Blanco, RN (peri-operative); Amber Williams (OR business); Teresa Haley (OR scheduling); Dee Dee Wroten, Crystal Osborne, Elvira Martinez (access services); Nancy Lind, RN, and Jessie Hawkins, RN (prep/recovery). Special thanks to the entire Surgical Access Services team who make these calls, the OR schedulers, and the Prep/Recovery charge nurses, who all made changes to their workflow to better serve patients.