 Nexalus users can spend more time on value-add tasks |
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A process designed for modern surgery list management
In every hospital and trust there is a need to reduce cancellations on the day of surgery. It’s not an easy thing to fix either - from how to know patients are ready and healthy for surgery to the elongated process of contacting them individually in the weeks running up to their procedure date.
Internally, there’s a lot of manual processing of lists and, at present, patients attend (or not, if DNA) on the day and face cancellations based on their clinician's review of their case.
We have built a system that has been designed hand-in-hand with one of the UK’s most respected trusts, UHNM, that will revolutionise the way that hospitals manage their patients, theatres and surgical units. The system combines patient and theatre booking data to create lists that will improve theatre utilisation, staff resourcing and mental wellbeing, and above all, patient satisfaction.
Booking an appointment
The patient is seen as normal in outpatients and is offered a self-service check-in option for their surgery.
This opts them into using the surgery check-in system and the information is stored in their patient record and passed into the theatre booking system. Non-digital users will be sent a letter and will be contacted by the clerical team before their surgery (they will still be displayed on the secretary dashboard and will be flagged for a call to check-in).
Checking-in online
The patient receives an SMS three weeks prior to their procedure date directly from the Nexalus using the Gov Notify messaging service. They can either confirm their attendance and check-in or cancel, by clicking on a link to a secure webpage using their device’s default browser – no apps are required to be downloaded.
Patients that confirm are asked a set of simple questions and, once complete, are checked-in for their procedure. As this is a web based service there are opportunities to share further information relating to their hospital visits (videos, maps and guides), as well as a link to store the procedure in their device’s default calendar.
Building dynamic theatre lists
The admin team have a full view of all patients scheduled for each day of surgery - whether they have successfully checked-in online, declined or have been rejected for surgery based on the responses to the online questionnaire. This now negates the use of Outlook diary entries and spreadsheets to organise lists. Everything is automated and patient procedures are displayed in an easy to use dashboard.
The system has all of the tools to help the secretary/list management team organise their lists for each speciality and clinician. They now only need to make calls to patients who have not responded to the online check-in messages.
Patients who are reached by phone can be checked-in by the secretary whilst on the call using Nexalus and then reviewed by the surgeon in the same way as digitally checked-in patients.
One of the other significant improvements in automating lists this way is that lists are managed in a central repository and workloads are interchanged during holidays and illness, between secretaries and specialities.
Surgeon 's review of patient's case
Each surgeon has their own account on Nexalus and they can view each day of surgery and their list of patients. The only difference is that this list can be reviewed before the day of surgery allowing clinical type cancellations to be removed from the list early enough to be replaced with more suitable cases.
The list shows patients who have checked-in and are ready for review. The surgeon can review their case and mark the patient suitable for surgery. This happens weeks before surgery and removes many of the reasons for cancellation on the day.
Patient participation
The patient is a key factor in the fight to eradicate DNAs on the day of surgery. There is a little ‘investment behaviour’ at work, where they have been through the process of checking-in and completing the online questionnaire.
We have seen a significant fall in DNAs using the check-in process as this is proving to be more effective than simply sending a reminder text to the patient.
50% reduction in avoidable cancellations
40-60% of cancellations offered to waiting list
Significant uplift in patient reassurance
Best of all Patient, Admin and Clinician are
all on the same page at last.