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A study of clinical and information management processes in the surgical pre-assessment clinic.

Bouamrane MM, Mair FS - BMC Med Inform Decis Mak (2014)

Bottom Line: Successful deployment and normalisation of innovative clinical and information management processes was possible because both local and national strategic priorities were synergistic and the system was developed collaboratively by the POA staff and the health-board IT team, resulting in a highly contextualised operationalisation of clinical and information management processes.Further concerted efforts from a range of stakeholders are required to fully integrate preoperative assessment within the health-board surgical care pathway.A substantial - yet unfulfilled - potential benefit in embedding information technology in routine use within the preoperative clinic would be to improve the reporting of surgical outcomes.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institute of Applied Health Sciences, University of Aberdeen, Scotland, UK. mbouamrane@abdn.ac.uk.

ABSTRACT

Background: Establishing day-case surgery as the preferred hospital admission route for all eligible patients requires adequate preoperative assessment of patients in order to quickly distinguish those who will require minimum assessment and are suitable for day-case admission from those who will require more extensive management and will need to be admitted as inpatients.

Methods: As part of a study to elucidate clinical and information management processes within the patient surgical pathway in NHS Scotland, we conducted a total of 10 in-depth semi-structured interviews during 4 visits to the Dumfries & Galloway Royal Infirmary surgical pre-assessment clinic. We modelled clinical processes using process-mapping techniques and analysed interview data using qualitative methods. We used Normalisation Process Theory as a conceptual framework to interpret the factors which were identified as facilitating or hindering information elucidation tasks and communication within the multi-disciplinary team.

Results: The pre-assessment clinic of Dumfries & Galloway Royal Infirmary was opened in 2008 in response to clinical and workflow issues which had been identified with former patient management practices in the surgical pathway. The preoperative clinic now operates under well established processes and protocols. The use of a computerised system for managing preoperative documentation substantially transformed clinical practices and facilitates communication and information-sharing among the multi-disciplinary team.

Conclusion: Successful deployment and normalisation of innovative clinical and information management processes was possible because both local and national strategic priorities were synergistic and the system was developed collaboratively by the POA staff and the health-board IT team, resulting in a highly contextualised operationalisation of clinical and information management processes. Further concerted efforts from a range of stakeholders are required to fully integrate preoperative assessment within the health-board surgical care pathway. A substantial - yet unfulfilled - potential benefit in embedding information technology in routine use within the preoperative clinic would be to improve the reporting of surgical outcomes.

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Related in: MedlinePlus

Patient’s circumstances & activities of daily living ((Dumfries & Galloway Royal Infirmary - Feb. 2013)).
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Figure 4: Patient’s circumstances & activities of daily living ((Dumfries & Galloway Royal Infirmary - Feb. 2013)).

Mentions: • Caring and patient centeredness are essential elements of the patient-nurse relationship in the perioperative pathway [41]. The patient integrated care pathway was designed from the very outset to be patient-centred (Figure 4). Two important categories of information collected by the nurses during the patient interview include: (i) information on patients’ personal circumstances and a comprehensive section dedicated to (ii) assessing activities of daily living. The routine provision of verbal and/or written information to patients during the POA interview is also explicitly integrated in the patient pathway and documented in the ICP. All patients are also provided with a pre-assessment information leaflet prior to – or during – their interview.


A study of clinical and information management processes in the surgical pre-assessment clinic.

Bouamrane MM, Mair FS - BMC Med Inform Decis Mak (2014)

Patient’s circumstances & activities of daily living ((Dumfries & Galloway Royal Infirmary - Feb. 2013)).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4012827&req=5

Figure 4: Patient’s circumstances & activities of daily living ((Dumfries & Galloway Royal Infirmary - Feb. 2013)).
Mentions: • Caring and patient centeredness are essential elements of the patient-nurse relationship in the perioperative pathway [41]. The patient integrated care pathway was designed from the very outset to be patient-centred (Figure 4). Two important categories of information collected by the nurses during the patient interview include: (i) information on patients’ personal circumstances and a comprehensive section dedicated to (ii) assessing activities of daily living. The routine provision of verbal and/or written information to patients during the POA interview is also explicitly integrated in the patient pathway and documented in the ICP. All patients are also provided with a pre-assessment information leaflet prior to – or during – their interview.

Bottom Line: Successful deployment and normalisation of innovative clinical and information management processes was possible because both local and national strategic priorities were synergistic and the system was developed collaboratively by the POA staff and the health-board IT team, resulting in a highly contextualised operationalisation of clinical and information management processes.Further concerted efforts from a range of stakeholders are required to fully integrate preoperative assessment within the health-board surgical care pathway.A substantial - yet unfulfilled - potential benefit in embedding information technology in routine use within the preoperative clinic would be to improve the reporting of surgical outcomes.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institute of Applied Health Sciences, University of Aberdeen, Scotland, UK. mbouamrane@abdn.ac.uk.

ABSTRACT

Background: Establishing day-case surgery as the preferred hospital admission route for all eligible patients requires adequate preoperative assessment of patients in order to quickly distinguish those who will require minimum assessment and are suitable for day-case admission from those who will require more extensive management and will need to be admitted as inpatients.

Methods: As part of a study to elucidate clinical and information management processes within the patient surgical pathway in NHS Scotland, we conducted a total of 10 in-depth semi-structured interviews during 4 visits to the Dumfries & Galloway Royal Infirmary surgical pre-assessment clinic. We modelled clinical processes using process-mapping techniques and analysed interview data using qualitative methods. We used Normalisation Process Theory as a conceptual framework to interpret the factors which were identified as facilitating or hindering information elucidation tasks and communication within the multi-disciplinary team.

Results: The pre-assessment clinic of Dumfries & Galloway Royal Infirmary was opened in 2008 in response to clinical and workflow issues which had been identified with former patient management practices in the surgical pathway. The preoperative clinic now operates under well established processes and protocols. The use of a computerised system for managing preoperative documentation substantially transformed clinical practices and facilitates communication and information-sharing among the multi-disciplinary team.

Conclusion: Successful deployment and normalisation of innovative clinical and information management processes was possible because both local and national strategic priorities were synergistic and the system was developed collaboratively by the POA staff and the health-board IT team, resulting in a highly contextualised operationalisation of clinical and information management processes. Further concerted efforts from a range of stakeholders are required to fully integrate preoperative assessment within the health-board surgical care pathway. A substantial - yet unfulfilled - potential benefit in embedding information technology in routine use within the preoperative clinic would be to improve the reporting of surgical outcomes.

Show MeSH
Related in: MedlinePlus