The aim of the project was to to improve patient and staff experience through better management of surgical activity at Fairfield Hospital by December 2020.
Aim
To reduce day of surgery (DOS) cancellations from 6% to 4% by December 2020, to reduce failure to attend rates in the pre admission clinic from 15% to 8% as well as increase patient and staff satisfaction as measured by My Experience Matters Survey.
Benefits
- Reduction of cancellations on day of surgery resulting in improved theatre utilisation.
- Reduction of failure to attend rates in pre-admission clinic resulting in providing timely care without any potential cancellations or delays.
- Improved communication between staff and patients resulting in increased satisfaction.
- Improved Surgical Patients Experience (measured via surveys) by addressing environmental concerns.
- Complying with Ministry of Health Targets and key performance indicators.
Background
An audit of Operating Theatre Services at Fairfield Hospital was conducted for the period of July 2018 to February 2019, with some recommendations made in relation to high cancellation rates on day of surgery. In addition there were common themes emerging from the patient My Experience Matters Survey (2018/19) relating to environmental barriers as well as communication gaps.
The People Matter Survey (2018/19) also highlighted a decrease in staff satisfaction and morale in staff who were key players in the surgical patient journey.
Implementation
- Implementation of daily and weekly multidisciplinary Risk Huddles.
- Day Only Ward patient waiting room rounding (daily).
- Setting up SMS reminders for Pre Admission Clinic and Surgery Dates.
- Review and amend correspondence sent to patients, in consultation with patients.
- Addressed environmental issues by installing automatic doors to Day Only Ward, relocating the doorbell, purchasing bear huggers and blanket warmers.
- Set up a Day Of Surgery Cancellations and Emergency Theatre utilisation Working Party.
Status
Sustained - The project has been implemented, is sustained in standard business.
Dates
June 2019 - December 2020
Implementation Sites
Fairfield Hospital
Partnerships
Community Participation Network at Fairfield, Consumer Network at Fairfield
Evaluation
- Reduced Day of Surgery Cancellation rates from 15% to 2.6% as of September 2020 (Surginet Data Cancellation Report).
- Reduced Failure to Attend Rates in Pre-Admission Clinic from 15% to 8% (Scheduling Reports).
- Improved patient satisfaction as per the My Experience Matters Survey from 90% (June-September 2019) to 100% (June-September 2020) of patients being satisfied with the service.
- Improved staff satisfaction as per the People Matter Survey.
Lessons Learnt
- Be prepared to invest time in people who do not support the idea or are difficult to engage.
- Change the presentation to suit the group you are trying to engage with, so that it is pitched appropriately to your audience.
- Consult broadly with stakeholders to ensure a wide range of views, experiences and ideas are sought – stay on their radar!
- Be flexible in your consultation approach, and ensure multiple forums are held with mixed stakeholder groups.
- Take advantage of opportunities for informal or coffee meetings, or hallway chats.
- Maintain focus on your objectives and be aware of scope creep.
References
- NSW Agency for Clinical Innovation, Operating Theatre Efficiency Guideline
Contact
Soji John
Peri-Operative Service Nurse Manager
Fairfield Hospital
Tel: 02 9616 8143
Soji.John@health.nsw.gov.au
Sylwia Michalak
Administration Manager
Fairfield Hospital
Tel: 02 9616 8898
Sylwia.Michalak@health.nsw.gov.au
Winona Ranyard
Nurse Unit Manager Day Only Ward and Pre-Admission Clinic
Fairfield Hospital
Tel: 02 9616 8829
Winona.Ranyard@health.nsw.gov.au
Shalin Kumar
Sustainable Access Manager
Fairfield Hospital
Tel: 02 9616 8594
shalin.kumar@health.nsw.gov.au
