Preadmission testing gets high marks from patients
Preadmission testing gets high marks from patients
95% of patients give high scores to SDS unit
After making dramatic changes in its preadmission process, Kettering (OH) Medical Center boosted its patient satisfaction scores in that area to 38% excellent and 57% very good or good. The hospital’s previous score was 34% excellent.
The patient satisfaction scores are determined by a survey developed by Solution Point in Nashville, TN. (See excerpt of survey, pp. 8-9.) Solution Point provides health care enterprises with information systems that measure and predict consumer demand, behavior, and satisfaction to improve the process and outcomes of care.
The preadmission process needs the attention of same-day surgery managers because insurance companies have changed the provision of care in this area, emphasizes Elizabeth Curtis, RN, access management coordinator at Kettering Medical Center. Previously, surgery patients could spend the night in the hospital before surgery, with plenty of time for preoperative teaching.
"Now we don’t have the luxury. There’s no time prior to surgery" or after surgery, Curtis says. "Patients aren’t really in any frame of mind to be educated. They’re anxious, medicated, in pain, and none of those are conducive to learning."
A well-thought-out preadmission program of testing and education can address this problem, she says. "That’s what we’ve tried to do: Give back patients what they had before. But we have to do it preoperatively, and of course, in a setting we hope is nonemergency so they can learn."
Here’s what they added:
• Pre-op teaching. Patient anxiety on the day of surgery was a significant concern for the preoperative teaching staff, says Lynn Schneider, RN, BSN, MSA, clinical nurse manager at Kettering. "They don’t comprehend well their instructions. They’re worried about going to surgery in 20 minutes, and they’re not concerned about how to take care of themselves at home."
The managers decided to bring in patients within about six days of surgery for preoperative education and meet with them postoperatively to answer any questions that had arisen.
• Centralized scheduling. Kettering consolidated the preoperative scheduling process to one phone call to register patients and schedule testing. This step improved patient and physician satisfaction. Previously, physician offices had to call each department to schedule pre-op tests, Curtis says. "They wanted patients to come in and have all this work done in a very timely manner so they didn’t have to come in one day for X-ray, one day for lab work, and one day for something else." Centralized scheduling addressed this concern.
• One-stop preadmission testing. Centralized scheduling didn’t solve all the problems, however. "We talked to patients and found out that while we could have them do testing on one day, we were running into glitches, sending them all over hospital," she says. Patients were going to radiology for pre-op tests, for example, and another department for an EKG. "They were trekking all over the hospital, dressing and undressing several times. It was a big dissatisfier." To find an answer, the departments began brainstorming. "The whole thing snowballed. "The orthopedic and cardiac product lines got involved."
After about a year and a half of work, the preadmission testing unit has been linked to centralized scheduling, she says. The unit makes one phone call to schedule patients for surgery and testing, and the pre-op assessment and teaching are planned for the same day, in order, so patients don’t waste time. EKGs, X-rays, and lab work are done in one room of the preadmission testing unit.
"We decided one stop would be wonderful, and that’s what we did," Schneider says.
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