Edward G M, Razzaq S, de Roode A, Boer F, Hollmann M W, Dzoljic M, Lemaire L C
University of Amsterdam, Academic Medical Centre, Department of Anaesthesiology, Leiden, The Netherlands.
Eur J Anaesthesiol. 2008 Apr;25(4):280-6. doi: 10.1017/S0265021507003122. Epub 2008 Jan 7.
Previous research has shown that a preoperative assessment clinic enhances hospital cost-efficiency. However, the differences in organization of the patient flow have not been analysed. In this descriptive study, we evaluated the consequences of the organization of the patient flow of a preoperative assessment clinic on its performance, by analysing two Dutch university hospitals, which are organized essentially differently.
In the final analysis, the study included 880 patients who visited either academic centre. The performance of the two preoperative assessment clinics was evaluated by measuring patient flow time, various procedure times and the total waiting time. Patients' age, ASA physical status and any preoperative tests requested by the physician were also recorded.
There was a significant difference in patient flow time between the two preoperative assessment clinics. More time was needed for the preoperative assessment when patients' ASA class was higher. The patient flow time was longer when electrocardiogram and venepuncture were performed at the general outpatient laboratory than when they were performed at the preoperative assessment clinic due to longer waiting times. More tests were requested when they were performed at the preoperative assessment clinic.
This study shows that the organization of patient flow is an important aspect of the logistic processes of the preoperative assessment clinic. It might influence patient flow times as well as the number of preoperative tests requested. Together with other aspects of logistic performance, patient satisfaction and quality of medical assessment, patient flow logistics can be used to assess the quality of a preoperative assessment clinic.
先前的研究表明，术前评估门诊可提高医院成本效益。然而，患者流程组织方面的差异尚未得到分析。在这项描述性研究中，我们通过分析两所组织方式存在本质差异的荷兰大学医院，评估了术前评估门诊患者流程组织对其绩效的影响。
最终分析纳入了两所学术中心的880例就诊患者。通过测量患者流程时间、各项操作时间和总等待时间，评估两家术前评估门诊的绩效。还记录了患者的年龄、美国麻醉医师协会（ASA）身体状况以及医生要求的任何术前检查。
两家术前评估门诊的患者流程时间存在显著差异。当患者的ASA分级较高时，术前评估需要更多时间。由于等待时间更长，在普通门诊实验室进行心电图和静脉穿刺时的患者流程时间比在术前评估门诊进行时更长。在术前评估门诊进行检查时，要求进行的检查更多。
本研究表明，患者流程组织是术前评估门诊物流流程的一个重要方面。它可能会影响患者流程时间以及术前检查的数量。与物流绩效的其他方面、患者满意度和医学评估质量一起，患者流程物流可用于评估术前评估门诊的质量。
