Pre-Admission Testing (PAT) Process Flow Optimization and Patient Chart Standardization for Elective Surgeries

Headnote

Abstract

This paper presents a comprehensive study of the redesign of a Pre-admission testing (PAT) process at a regional hospital where a dedicated PAT center is anticipated. PAT processes require efficient handling of patient flow and patient information flow to reduce potential delays of elective surgeries. The objective of this study is to adapt and streamline PAT process flow. A combination of observations, time studies, and data analyses has been applied to this research. Based on the analyses, the turnaround time of patient charts before surgery and the lack of communication before and after the PAT appointment are identified as potential bottlenecks. Therefore, increased patient chart prep and chart assembly process flows and reallocation of office space have been proposed. Patient chart and medical form standardization has also been proposed for better communications.

Keywords

Pre-admission testing (PAT), Outpatient surgery, Information process flow, Chart prep and assembly

1. Introduction

Outpatient health care has a significant role in the overall health care system in the United States. Due to many advances in technology, health care products and procedures, many of today's health care needs are conducted through the outpatient care sector [1]. An important aspect of outpatient care is the pre-admission testing (PAT) for elective surgeries. The testing is done to find any potential conditions that may have an effect on the surgery [2]. Separate facilities have been built on hospital campuses for ambulatory and pre-admission testing centers. These centers have been developed to streamline the pre-admission process [3]. As more and more surgeries become outpatient procedures, the importance of pre-admission testing has also increased [4].

For PAT, the required tests that need to be complete prior to the surgery date include, blood work, radiology, EKG and the history and physical examination of the patient. All patients must have a history and physical examination; the other diagnostic tests are ordered by the physician depending on the surgery type and patient characteristics. These tests need to be completed anywhere between three to fifteen days prior to scheduled surgery procedure; this also depends on the characteristics of the patient and the type of surgery. Another aspect of PAT, that is equally important, is patient education. It is necessary for the patient to be physically and mentally prepared for...