Redesigning the pre-anesthesia clinic at Providence Hospital & Medical Center.
UNLABELLED: Using the critical incident technique, a team at Providence Hospital & Medical Center found that patients' greatest source of dissatisfaction with out-patient surgical services was the waiting they experienced in the pre-anesthesia clinic. After analyzing the process, the team discovered that patients spent an average of 32 minutes waiting. The team reconceptualized the process so that individual patient appointments are now made, and anesthesiologists scrutinize each preoperative test ordered. RESULTS: Average patient throughput time dropped from 58 minutes to 36.5 minutes. Routine preoperative tests dramatically decreased (eg, 35 percent drop in complete blood counts and urinalyses). Patient waiting time was completely eliminated unless appointment and arrival times differed significantly. Patient satisfaction with the entire outpatient surgical experience rose from 85 percent to 96 percent.