specialist case study: improvements at the royal victorian eye & ear hospital

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Surgical Assessment Centre (SAC)

Jane Habgood

We are a teaching and research hospital specialising in Eye, Ear, Nose and Throat surgery

Founded 1863 – More than 140 years continuous service to the Victorian community

One of about thirty hospitals world-wide devoted exclusively to diseases of the eye, ear, nose and throat

Our History

One of fifteen Metropolitan Health Services

Provide State-wide specialist Health Services

A busy hospital providing elective & emergency

services

• 46,000 Emergency Department attendances

• 13,500 Operations

• 175,000 Outpatient appointments

Our Services

Hospital Layout

Operating Theatre Suite & SPC

Day Surgery

Short Stay Care Centre

Pre-admission

Medihotel

Ward 8 / Bed Management

Admissions GF

3rd

4th

6th

7th

8th

Basement

Entrance

Smorgon Family

Wing Peter Howson Wing

ENT outpatient

General eye outpatient

Special eye outpatient

SAC

3rd

GF

1st

5th

Surgical Bookings

With redevelopment of ED the SAC process was

reviewed.

A Project Team mapped the current SAC patient flow

& process.

The aim was to develop a patient centred care

approach that would reduce delays at all stages of

the process.

Better understanding of patient flow, bottlenecks and

constraints allowed a new surgical assessment

process to be implemented.

Background

Check consents are complete.

Check Health Questionnaire complete.

Identify which pre-admission clinic the patient attends

Send Category 1 patients to pre-admission clinic

Give Category 2 patients pre-admission appointments

Explain waiting times for all categories

Previous Role of SAC Nurse

Surgical Assessment Centre (SAC)

Increased appointment time due the

patient having to attend SAC

Disadvantages

Location and staffing

Patients reading or taking their

Medical History home

Outpatients SAC Home

Outpatients SAC Pre-Admission

Home

Patient Journey

Streamline process of patient referral for surgery

Improve patient experience using a more patient

centred approach

Reduce risk of patient reading or taking their

Medical History home

Reduce appointment times

Project Aims

Changes

checks consents are completed

gives Health Questionnaire to complete and post back &

stamps consent to confirm it was given

sends Cat. 1 patients direct to Pre-Admission

sends Medical History to Surgical Bookings

Outpatients Clerk

Surgical Bookings.

Registers patient on the waiting list

sends Medical History to triage Nurse in Pre-Admission

Triage (SAC) Nurse in Pre-Admission Dept.

checks and files the returned Health Questionnaire

into Medical History

follows up any outstanding Health Questionnaires

allocates Pre-Admission clinics and appointments

for Cat. 2 patients

attends VRU Outpatient clinics and pre-admits any

Cat. 1 patients

Changes

Outcomes

No Metric / KPI Baseline Post Go-Live Evaluation

1 Transfer of Patient Histories

to SBU 2 x daily 2 x daily good

2 % questionnaires returned

within 2 weeks no baseline 85-87% good

3 Number of consents stamped

in OPD no baseline 90% good

4 Histories going to HIS and not

to SBU 0-2 /week 4-5 /week poor

5 Length of combined

appointment time 150 mins 130 mins good

6 % Cat. 1 patients not pre-

admitted on day of consent 0% 0% good

New Patient Journey

Outpatients Home

Outpatients Pre-Ad Home

Cat. 1

All others

Outcomes

Any questions?