Skip to main content
SpringerLink
Log in

Steigerung von Effizienz und Patientenzufriedenheit durch strukturierte Prozesse am Beispiel der Prämedikationsambulanz

Increasing efficiency and patient satisfaction by structured clinical processes in presurgical visits

  • Originalien
  • Published:
Der Unfallchirurg Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Unter logistischen und juristischen Gesichtspunkten ist präoperative Aufklärung für den Chirurgen eine Herausforderung.

Material und Methoden

Nach kompletter Aufklärung zum Informationsgewinn und zur Zufriedenheit mit medizinischen und logistischen Abläufen wurden 450 konsekutive Patienten schriftlich befragt. Verglichen wurde die Patientenzufriedenheit mit reell gemessenen Prozesszeiten.

Ergebnisse

Die mittlere Aufklärungsdauer lag bei 36,1±0,8 min. Die Prämedikation vollzog sich bei Patienten ohne Termin signifikant schneller. Ältere Patienten waren mit den zeitlichen Abläufen und der chirurgischen Aufklärung zufriedener als jüngere. Längerer Patientenkontakt führte zu einer besseren Einschätzung der medizinischen Kompetenz des Arztes und zu einer höheren Zufriedenheit mit der chirurgischen Aufklärung. Reell gemessene Wartezeiten beeinflussten die Patientenzufriedenheit nicht.

Schlussfolgerung

Die Prämedikationsambulanz erlaubt eine schnelle Patientenaufklärung im juristisch korrekten Rahmen. Dies führt zu einer hohen Patientenzufriedenheit, verbunden mit einem hohen Informationsgewinn für Patienten. Klinische Behandlungspfade tragen zu einer besseren Patienteninformation bei.

Abstract

Background

In clinical routine the process of presurgical visit and signed informed consent is imperfectly realized in surgical patients.

Material and methods

A total of 450 consecutive patients were interviewed after a presurgical visit for informed consent using a questionnaire. The aim of the study was to investigate the amount of knowledge gained by informed consent. Patient satisfaction with medical treatment and logistic workflow was correlated with real waiting times and process times.

Results

Mean information duration was 36.1±0.8 min. In patients with no appointed time, waiting times and overall stay was shorter. Patient’s satisfaction with medical treatment and time process was significantly higher in the elderly. Longer conversation with the surgeon was associated with a higher assessment of surgeons’ medical experience irrespective of his specialist’s state. Real waiting times did not affect patient’s satisfaction.

Conclusion

A walk-in clinic for presurgical visit and signed informed consent can improve patient satisfaction. It allows an excellent patients information in an appropriate time-frame. Clinical pathways can improve patient satisfaction and information concerning the lining up operation and disease pattern.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. Askew G, Pearson KW, Cryer D (1990) Informed consent: can we educate patients? J R Coll Surg Edinb 35:308–310

    PubMed  CAS  Google Scholar 

  2. Bar-Dayan Y, Leiba A, Weiss Y et al (2002) Waiting time is a major predictor of patient satisfaction in a primary military clinic. Mil Med 167:842–845

    PubMed  Google Scholar 

  3. Bates T (2001) Ethics of consent to surgical treatment. Br J Surg 88:1283–1284

    Article  PubMed  CAS  Google Scholar 

  4. Brezis M, Israel S, Weinstein-Birenshtock A et al (2008) Quality of informed consent for invasive procedures. Int J Qual Health Care 20:352–357

    Article  PubMed  Google Scholar 

  5. Chan Y, Irish JC, Wood SJ et al (2002) Patient education and informed consent in head and neck surgery. Arch Otolaryngol Head Neck Surg 128:1269–1274

    PubMed  Google Scholar 

  6. Dansky KH, Miles J (1997) Patient satisfaction with ambulatory healthcare services: waiting time and filling time. Hosp Health Serv Adm 42:165–177

    PubMed  CAS  Google Scholar 

  7. Deutsch E (1989) The right not to be treated or to refuse treatment. Med Law 7:433–438

    PubMed  CAS  Google Scholar 

  8. Digiacomo EV, Kramer LD (1982) A study of emergency unit waiting time. QRB Qual Rev Bull 8:10–13

    PubMed  CAS  Google Scholar 

  9. Dugdale DC, Epstein R, Pantilat SZ (1999) Time and the patient-physician relationship. J Gen Intern Med 14 (suppl 1):S34–S40

    Article  PubMed  Google Scholar 

  10. Gross DA, Zyzanski SJ, Borawski EA et al (1998) Patient satisfaction with time spent with their physician. J Fam Pract 47:133–137

    PubMed  CAS  Google Scholar 

  11. Haas JS, Cook EF, Puopolo AL et al (2000) Is the professional satisfaction of general internists associated with patient satisfaction? J Gen Intern Med 15:122–128

    Article  PubMed  CAS  Google Scholar 

  12. Harnett MJ, Correll DJ, Hurwitz S et al (2010) Improving efficiency and patient satisfaction in a tertiary teaching hospital preoperative clinic. Anesthesiology 112:66–72

    Article  PubMed  Google Scholar 

  13. Hermann M (2002) 3-dimensional computer animation – a new medium for supporting patient education before surgery. Acceptance and assessment of patients based on a prospective randomized study – picture versus text. Chirurg 73:500–507

    Article  PubMed  CAS  Google Scholar 

  14. Hoermann S, Doering S, Richter R et al (2001) Patients‘ need for information before surgery. Psychother Psychosom Med Psychol 51:56–61

    Article  PubMed  CAS  Google Scholar 

  15. Jackson JL, Chamberlin J, Kroenke K (2001) Predictors of patient satisfaction. Soc Sci Med 52:609–620

    Article  PubMed  CAS  Google Scholar 

  16. Kayser MC, Von Harder Y, Friemert B et al (2006) Patientenaufklärung – Fakt und Fiktion. Chirurg 77:139–149

    Article  PubMed  CAS  Google Scholar 

  17. Kerwat KM, Kratz CD, Olt C et al (2004) Marburg model for optimization of stratification of the anaesthesiological risk. Anaesthesist 53:856–861

    Article  PubMed  CAS  Google Scholar 

  18. Klima S, Hein W, Hube A et al (2005) Multimedia preoperative patient information. Chirurg 76:398–403

    Article  PubMed  CAS  Google Scholar 

  19. Kratz CD, Christ M, Maisch B et al (2004) Pramedikationsvisite. Kosten sparen auf Kosten des Patienten? Anaesthesist 53:862–870

    Article  PubMed  CAS  Google Scholar 

  20. Krukemeyer MG, Pflugmacher I, Spiegel HU (2007) Indications for surgery from the viewpoints of surgeon and juror. Unfallchirurg 110:896, 898–901

    Article  PubMed  CAS  Google Scholar 

  21. Lewis PJ, O’Keefe L, Adcock S (1991) Patients who were given information sheets have better postoperative recall of information. J R Coll Surg Edinb 36:206–207

    PubMed  CAS  Google Scholar 

  22. Lin CT, Albertson GA, Schilling LM et al (2001) Is patients‘ perception of time spent with the physician a determinant of ambulatory patient satisfaction? Arch Intern Med 161:1437–1442

    Article  PubMed  CAS  Google Scholar 

  23. Lungen M, Stollenwerk B, Messner P et al (2008) Waiting times for elective treatments according to insurance status: a randomized empirical study in Germany. Int J Equity Health 7:1

    Article  PubMed  Google Scholar 

  24. Probst JC, Greenhouse DL, Selassie AW (1997) Patient and physician satisfaction with an outpatient care visit. J Fam Pract 45:418–425

    PubMed  CAS  Google Scholar 

  25. Robinson G, Merav A (1977) Informed consent: recall by patients tested postoperatively. Conn Med 41:223–225

    PubMed  CAS  Google Scholar 

  26. Schilling MK, Richter S, Jacob P et al (2006) Klinische Behandlungspfade. Erste Ergebnisse des systematischen IT-gestützten Einsatzes an einer chirurgischen Universitatsklinik. Dtsch Med Wochenschr 131:962–967

    Article  PubMed  CAS  Google Scholar 

  27. Schuld J, Richter S, Folz J et al (2008) Einfluss IT-gestützter klinischer Behandlungspfade auf die Patientenzufriedenheit an einer chirurgischen Universitätsklinik. Dtsch Med Wochenschr 133:1235–1239

    Article  PubMed  CAS  Google Scholar 

  28. Shepherd HA, Bowman D, Hancock B et al (2000) Postal consent for upper gastrointestinal endoscopy. Gut 46:37–39

    Article  PubMed  CAS  Google Scholar 

  29. Snyder-Ramos SA, Seintsch H, Bottiger BW et al (2003) Development of a questionnaire to assess the quality of the preanesthetic visit. Anaesthesist 52:818–829

    Article  PubMed  CAS  Google Scholar 

  30. Wallace LM (1986) Informed consent to elective surgery: the „therapeutic“ value? Soc Sci Med 22:29–33

    Article  PubMed  CAS  Google Scholar 

  31. Wilhelm D, Gillen S, Wirnhier H et al (2009) Extended preoperative patient education using a multimedia DVD-impact on patients receiving a laparoscopic cholecystectomy: a randomised controlled trial. Langenbecks Arch Surg 394:227–233

    Article  PubMed  CAS  Google Scholar 

  32. Zieren J, Paul M, Menenakos C et al (2006) Videoinformationsfilm vor Leistenhernienoperationen. Erste klinische Erfahrungen. Chirurg 77:150–153

    Article  PubMed  CAS  Google Scholar 

Download references

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

  1. Klinik für Allgemeine Chirurgie, Viszeral-, Gefäß- und Kinderchirurgie, Universitätsklinikum des Saaarlandes, Kirrberger Str. 1, 66424, Homburg/Saar, Deutschland

    J. Schuld, M.R. Moussavian, B. Frank, U.A. Schmidt, O. Kollmar, M.K. Schilling & S. Richter

Authors
  1. J. Schuld
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M.R. Moussavian
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. B. Frank
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. U.A. Schmidt
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. O. Kollmar
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M.K. Schilling
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. S. Richter
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to J. Schuld.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schuld, J., Moussavian, M., Frank, B. et al. Steigerung von Effizienz und Patientenzufriedenheit durch strukturierte Prozesse am Beispiel der Prämedikationsambulanz. Unfallchirurg 114, 1091–1098 (2011). https://doi.org/10.1007/s00113-010-1840-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00113-010-1840-6

Schlüsselwörter

Keywords

Search

Navigation