Archive June 2014 XV, No. 6

Perfect Your Pre-Admission Process

Advice for starting every patient experience on the right foot.

David Bernard, Senior Associate Editor


— A GOOD START Don't underestimate the value of preparation and explanation.

First impressions are everything. For surgical facilities, first impressions take a lot of preparation in the time before each patient's procedure to ensure day-of-surgery success. Here are some practical solutions for smoothing out your pre-admission process, and reducing delays and canceled cases.

Online forms can avert chaos
Do you remember winter? Jen Watson, BSN, the pre-op/PACU manager at Charlotte (N.C.) Surgery Center does. In the thick of the record-setting snow and ice storms, she and her staff experienced a 2-day closure, the sort of contingency that can wreak havoc on a busy surgery center.

"The ripple effect of an unexpected closure can last days as surgeries are rescheduled and nurses are left scrambling to play catch-up on pre-admission calls," she says. Re-opening is typically a chaotic event. Staff must triage patients upon their arrival, going over their medical histories on the day of surgery instead of a couple of days beforehand, potentially pushing their surgical start times back hours or canceling them entirely.

But it was "smooth sailing" at Ms. Watson's center, even with 44 cases scheduled. "All surgeries occurred without delay, which would not have been possible had we not brought our pre-admissions process online," she says. "We re-opened without missing a beat."

The online pre-admissions portal the center implemented let nurses access the system, remotely and securely, via their home Internet connections to keep the center's upcoming schedule on track. During their snow days at home, they could review patient-supplied pre-op histories for completeness, contacting patients for more information and inputting it into the system. Anesthesia providers and surgeons were also able to review the histories for any necessary medical clearances.

Even on non-snow-days, however, giving your patients the opportunity to fill out their forms online, on their own time, well before surgery, offers advantages. "We still call every patient to verify the time they're supposed to be here, to go over the details and specific instructions," says Ms. Watson. "But everything is much more efficient when you don't have a nurse on the phone taking 20 minutes with each patient to go over the questions and taking down their medications list. And we tell them, 'If you have Internet access, you don't have to be on the phone with me for however long it takes.'"

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