TITLE: THE POTENTIAL IMPACT OF REDUCING REPEAT PATIENT VISITS IN A PREOPERATIVE PATIENT TESTING CENTER

AUTHORS: Richard H. Epstein, MD, Richard R. Bartkowski, MD, PhD, Steven Bell, MD, David Gratch, DO
AFFILIATION: Jefferson Medical College, Philadelphia, PA.

INTRODUCTION: At our hospital, the Department of Anesthe- siology runs the Patient Testing Center (PTC), in which nearly all patients scheduled for outpatient or day of admission surgery receive preoperative evaluations. We currently are reviewing many of the processes in the PTC in an attempt to improve efficiency, decrease patient evaluation times, and reduce staffing requirements. Eliminating revisits for patients who have been previously evaluated and are scheduled for another procedure is a potential area of savings. At the present time, patients who are scheduled for two related procedures (e.g., a breast biopsy followed by a lumpectomy and axillary dissection) only need to be seen in the PTC once. We wanted to determine how frequently other patients are undergoing multiple PTC evaluations to determine the potential impact on the operation of our center from eliminating these visits.
METHODS: PTC visits are scheduled using ORSOS (Per-Sé Technologies). The registration table covering 10/23/98 to 7/27/ 99 was imported into Access 97 (Microsoft) and queried for the presence of duplicate record numbers (unique for each patient). We determined the frequency distribution of multiple visits and the percent of patients seen within 3, 4, 5, and 6 months of their initial encounter.
RESULTS: There were 12,731 visits to the PTC during the 9- month interval (66 patients/day), 97% of which were first visits. 380 appointments were for patients who had been seen previously during the interval (Tables 1,2).

Table 1. Distribution of Repeat Visits

Table 2. Time Course of Repeat Visits

DISCUSSION: Patient revisits to the PTC within 6 months occurred infrequently, accounting for only less than 3% of the total volume. If these visits were to be eliminated, the volume would decrease by approximately 2 patients per day, a relatively insignificant amount. Although eliminating these visits would probably be convenient for the patients involved, the impact on the workload of the PTC would be minimal.