Key result
Redesigning the preoperative evaluation clinic using DMAIC methodology improved patient access by 14% (P<.001) and triage efficiency by 30% (P<.001).
Why the study?
Increased patient volume and shortened turnaround times bottlenecked access in a preoperative evaluation clinic that had outgrown its initial practice model.
Does a clinic redesign using DMAIC methodology improve access, efficiency, and staff satisfaction in a preoperative evaluation clinic?
Does a clinic redesign using DMAIC methodology improve access, efficiency, and staff satisfaction in a preoperative evaluation clinic?
A multidisciplinary quality improvement initiative using DMAIC methodology significantly improved patient access, triage efficiency, operating margin, and staff satisfaction in a preoperative evaluation clinic.
Answers are grounded in this paper and cite their sources.
May improve access in high-volume POE clinics; leaves open generalizability to other centers.
In 2008, Mayo Clinic in Jacksonville, Florida, developed the preoperative evaluation (POE) clinic under the department of anesthesiology to provide preoperative history and physical examination, and medical optimization. Over time, the POE clinic expanded to accommodate more than 90% of surgical patients, outgrowing the initial practice model. The increased patient volume with shortened turnaround times bottlenecked patient access. A multidisciplinary quality improvement team used Define, Measure, Analyze, Improve, and Control methodology to understand the issues, test potential solutions, and develop sustainable processes. With progressive Plan-Do-Study-Act cycles, it moved from small internal tests of change to implementation throughout the institution. Patient access improved by 14% ( P < .001) and triage efficiency by 30% ( P < .001). These elements led to a 14% improvement in operating margin and a 24% improvement in staff satisfaction. Sustainability was ensured with an accessible dashboard of performance indicators.
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Irizarry-Alvarado et al. (2018) studied Surgical patients requiring preoperative evaluation. Preoperative evaluation clinic redesign using DMAIC methodology vs. Initial practice model was evaluated on Patient access and triage efficiency (p=<.001). Redesigning the preoperative evaluation clinic using DMAIC methodology improved patient access by 14% (P<.001) and triage efficiency by 30% (P<.001).
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