November 2001

Measuring Improvement Template
Organisation:
West Gippsland Healthcare Group
Project Title:
Redesigning admission processes for elective surgery in a
rural setting
Project Leader:
Problems/Baseline
Measure
Sandee Bicknell
Median time from presentation to ready for theatre initially 3 hours
45 minutes. Some patients were waiting as much as 6 hours.
Aim & Target To reduce median time from presentation to ready for theatre to 90
minutes
Measures
(describe briefly)
The median time it takes for a patient to be admitted and prepared
for theatre.
Sampling Plan (in point form)
Measured from presentation to admission clerk to fully prepared for theatre in day surgery
cases.
A sample of 8 patients per fortnight will be measured when changes have started to be
implemented.
Note there was no collection of data for September as the trial had not commenced. October
data was based on the 2 patients admitted in the trial group.
Insert graph
here
Time from presentation to ready for theare
Time in minutes
250
200
150
100
50
Only 2
patients
admitted
from trial
group in
Oct
Sample
Target
0
July Aug Sep Oct Nov Dec

Brief Description of Changes
Key performance measures are being collected and fed back to clinical areas for discussion
and corrective action. This is resulting in the tightening of
compliance to the policy on consents, and review of theatre
starting times.
Trial of redesigned preadmission process has commenced.
Issues, Successes, Achievements
Since last Measuring template.
Trial on Orthopaedic patients has been in operation for 3 weeks
2 patients have completed the full process, attending pre-admission and been operated on.
Early measurable results have been very rewarding.
o 10 patients have been assessed by the preadmission service.
o 5 late cancellations have been prevented.
(Statistically the Preadmission Service trial has seen approximately 3% of
total patients admitted for the month and reduced preventable
cancellations by approximately 11%.) Data quality will improve as more
patients are seen through the new process.
o Patients bought forward to fill cancellations have been prepared in
adequate time adding greatly to patient satisfaction and assisting in
improved theatre utilisation.
o Patients expectations on time required to attend the Preadmission
Service were satisfied with all patients being seen within the allotted
time frame.
o The median time frame in August from admission to ready for theatre
was 176 minutes. Our first 2 patients were comfortably admitted and
ready for theatre in 30 minutes.
o Improved discharge planning. With three direct referrals to Post Acute
Care and one to ACAT from Preadmission. (Discharge planning had
previously commenced on the ward at time of admission)
o Ward staff time required to admit the patient on the ward was reduced
from an average of 30 minutes to 10 minutes.
o Early feedback from staff has been very positive.