BENCHMARKING THE PERIOPERATIVE PROCESS .1. PATIENT ROUTING SYSTEMS - A METHOD FOR CONTINUAL IMPROVEMENT OF PATIENT FLOW AND RESOURCE UTILIZATION

The article presents an overview of the design and application of a re al-time patient routing system, based on barcode and local area networ k technology, that was designed to track the progress of patients duri ng the perioperative process. We present data on all patients undergoi ng ambulatory surgery. Patients' progress during their surgical stay w as recorded at 17 strategic events using this real-time patient tracki ng technology. These times were used to identify inefficiencies in the perioperative process by identifying bottlenecks and areas of high va riation. We found that both raw and actual operating room (OR) utiliza tion efficiency was less than 50%. Points of high variation in a patie nt's progress occurred during the time from admit to the hospital unti l the patient was ready for the OR; the time from when a patient was r eady for the OR until they were called for; and the time a patient spe nds in the OR preoperative holding room. Causes for variation were ide ntified and traced back to individual procedures, activities, and work processes. Multidisciplinary improvement teams were created to improv e the pinpointed problem areas. The real-time patient routing system i s a process that has proven to be highly valuable to all participants in the surgical process in bringing about rational, data driven effici encies in perioperative services. This process has the potential to fa cilitate multidisciplinary cooperation in efforts to contain and reduc e costs of perioperative services. (C) 1997 by Elsevier Science Inc.