Abstract
Patient care transitions have been shown to be critical points at which failure as well as recovery from potential failure may occur. The purpose of this research was to identify transitions in patient care and the flow of associated information at different steps in the outpatient surgery preoperative care process and, in turn, attempt to identify breakdowns in the information flow process and their ramifications. A study of one organization’s preoperative process for outpatient surgery was conducted, employing four means of data collection to gather information on preoperative work processes: employee shadowing, patient shadowing, clinic observation, and dictated feedback. Various facilitators and obstacles in information flow were found to be present in the preoperative care process. Obstacles often resulted in negative consequences for healthcare providers and patients. Helping care providers understand how their actions affect the various elements of the preoperative process, through improved awareness, may be one way to improve information flow problems within the outpatient surgery process.
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Acknowledgments
Funding provided by AHRQ Grant # P20 HS11561-01 (PI: Pascale Carayon) and AHRQ Institutional Training Grant #HS000083 (PI: Dennis Fryback).
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Appendices
Appendix A: Shadowing tool
Appendix B: Dictation guide
Throughout your preoperative-related work today...
Did you experience any problems, delays, or frustrations with obtaining necessary patient documents or information?
If yes,
What type of documents/information was it (e.g., type of form, electronic vs. hardcopy)?
Where did the document/information come from or where was it supposed to come from (e.g., referring physician, origin of consult)?
Who delivered or was supposed to deliver the documents/information (e.g., patient, referring physician)?
Was there any documentation/information that was not available to you when you needed it?
If yes,
Why was the needed documentation/information not available?
How is this documentation/information obtained?
Who is responsible for getting this documentation/information?
Was there any documentation/information that was incomplete or not adequate?
If yes,
Please describe the problems with the documentation/information as to why it was incomplete or inadequate.
Please provide any additional comments concerning issues of information availability, access or flow.
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Schultz, K., Carayon, P., Hundt, A.S. et al. Care transitions in the outpatient surgery preoperative process: facilitators and obstacles to information flow and their consequences. Cogn Tech Work 9, 219–231 (2007). https://doi.org/10.1007/s10111-007-0081-0
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DOI: https://doi.org/10.1007/s10111-007-0081-0