Evidence-Based Practice Poster Session (Posters #1-#10)
3 - From Clinic to Operating Room - Communication Improvement Project in the Ambulatory Setting
Clinical Issue: Patients scheduled for GI endoscopy procedure receive pre-operative phone calls 24hours before the procedure. Based on patient feedback 24 hours is not sufficient time for patient to prepare for the procedure and establish PRE and POST operative logistics. DESCRIPTION OF TEAM: Ambulatory clinic nurses, Ambulatory Surgery pre-operative nurse, ambulatory surgery leadership PREPARATION AND PLANNING: After the process improvement objective was finalized the team met to identify opportunities in each step of the process. Data collection plan was approved and target date set.
Assessment: Ingalls Same Day Surgery (ISDS) is a free standing Ambulatory Surgical Center in Tinley Park, IL that is affiliated with University of Chicago Ingalls Memorial Hospital. University of Chicago GI group is performing GI endoscopy cases at ISDS. UChicago GI group is seeing patients at Orland Park Center of Advanced Medicine and schedule procedures at Tinley Park. Orland Park location is using EHR and ISDS is on paper. Multiple locations and different patient records system create multiple obstacles for timely pre-op assessment phone calls. A multidisciplinary team created process map for each step of the procedure scheduling routine from patient being seen in the ambulatory clinic to pre-operative phone call. The team was able to gain insight into current state. The project team reviewed the process map and identified opportunities to streamline and simplify communication between all stakeholders. IMPLEMENTATION: Our implementation focused on two areas – Clinic and Ambulatory Surgery Center. In the clinic we have reviewed After Visit Summary sheet and improved instructions for patients, In the ASC we arranged for EHR access for ASC staff, improved ASC pre-op staffing and workflow and worked on the telecom issues to allow for better phone communication and information. OUTCOME: Pre-operative phone call lead time was increased to 48-72 hours from 24. IMPLICATIONS FOR PERIOPERATIVE NURSING: Increased lead time for pre-op screening phone call improves patient preparedness for the procedure and decreases stress level.