Enhancing Efficiency in a Military Preanesthetic Assessment Clinic

Enhancing Efficiency in a Military Preanesthetic Assessment Clinic


Name: Jamie & Marko Cedola & Benito

Rank: CPT; CPT


Year: 2016


Enhancing Efficiency in a Military Preanesthetic Assessment Clinic.
Jamie Cedola, BSN CPT/AN and Marko Benito, BSN CPT/AN
IDENTIFICATION OF THE PROBLEM: Fort Belvoir Community Hospital’s (FBCH) Preanesthetic Clinic (PAC) suffers from long patient transit, waiting time and high provider idle time.
EBP QUESTION/PURPOSE: The purpose of this project is to decrease patient waiting, transit, and provider idle times by applying evidence-based alternative Preanesthetic Assessment Clinic patient flow designs.
METHODS/EVIDENCE: The team conducted a two-day on site PAC observation and a systematic literature review. PubMed was utilized, limited to articles published in English. Critical appraisal was conducted using the G.R.A.D.E. system (Grading of Recommendations Assessment, Development, and Evaluation).
SIGNIFICANCE OF FINDINGS/OUTCOMES: The literature review generated 109 references and eight articles met the selection criteria. The review revealed there is agreement that utilizing PACs reduce overall cost when compared to admitting patients in the hospital prior to day of surgery. There is an increase in patient satisfaction and decrease wait times when appointment scheduling is based on the American Society of Anesthesiology (ASA) functional classification.
FBCH’s PAC average transit times for three group of patients based on their functional status include ASA I (n=11): 50 mins; ASA II (n=41): 50 mins and ASA III (n=8) 70 mins.
SUSTAINMENT AND DISSEMINATION: The intent of this systematic review and observation was to lay the groundwork for the use of a simulation program presenting alternative PAC designs to increase efficiency. Findings will be disseminated to the Perioperative staff members and leadership.
IMPLICATIONS FOR MILITARY NURSING AND FUTURE RESEARCH: Military health care facilities can utilize simulation programs to compare the current practice and the simulated clinic designs to increase efficiency without disrupting the clinic activities during patient care.
KEYWORDS: Prenaesthetic clinic, patient wait times, clinic designs, Simulation