Session P92.6

Analysis and Monitoring of Patient Logistics in the Cardiology Outpatient Clinic

WA Dijk*, R Hoekema, MJ van der Vlugt, WRM Dassen,
ET van der Velde, N van der Putten

University Medical Center
Groningen, Netherlands

The aging of the general population, and high prevalence of cardiovascular diseases have resulted in saturation of the capacity of outpatient clinics and functional test laboratories. This commonly results in an extremely long time period between the onset of complaints and the final diagnosis and the start of treatment. In the Dutch University Medical Centers several novel initiatives have been developed to decrease the waiting time for an out-patient visit. The ICIN, Interuniversity Cardiology Institute of the Netherlands, has combined these initiatives in a project consisting of four main phases: 1) analysis of the present situation; 2)comparison of the results of the different centers; 3)development of a continuous improvement model; 4)development of a computer system for improving the workflow and monitoring patient throughput. The first two phases revealed similar conclusions for the different medical centers: 1)the number of follow-up visits is very high (about four times larger than the number of first visits); 2)the waiting time for echocardiography is the bottle neck at functional tests; 3) no-show of patients is too high (about 20% for echocardiography); 4)trainees are applying for more functional tests than senior cardiologists. The continuous improvement model is based on the definition of a revised process, creating indicators and defining the hot points of the process. At the moment we are developing action plans based on simplifying these hot points and eliminating the rest of the process. Our action plans include among others: 1)more screening echocardiography (half the time of a standard echocardiography); 2) development of a computerized structured report system; 3) creating an electronic network for fast cross enterprise sharing of electronic results of screening tests made throughout a hospital’s region (IHE XDS); 4) minimizing the number of follow-up visits. For monitoring the influence of these action plans we are developing a 'dashboard' system giving information about the indicators in the model. Finally, a number of hospitals are implementing a web-portal for patients to check and modify their appointment or consult their cardiologist.

(Abstract Control Number: 304)