Quality within cost containment: a study of the satisfaction of patients and healthcare providers with the introduction of a pre-admission program at St. Clare's Mercy Hospital

• Main Author: Valvasori, Greta
• Format: Thesis
• Language: English
• Published: Memorial University of Newfoundland 1995
• Subjects: Canada; Newfoundland
• Online Access: https://research.library.mun.ca/10582/; https://research.library.mun.ca/10582/1/Greta_Valvasori.pdf

Surgery patients constitute a large percentage of in-house hospital patients. While once customary, admitting elective surgical patients' one to two days before surgery is no longer an accepted practice. With pressure increasing to contain health care costs, hospital stays are becoming shorter. As health care dollars decrease and shortages of surgical beds increase, most hospitals are looking for ways to improve their efficiency with decreasing resources. As a result, same day admission for many procedures is rapidly becoming a commonplace hospital cost containment program. In such programs, patients undergoing elective surgery receive preoperative testing, preparation, and education on an outpatient basis. Patients are admitted to hospital on the day of surgery. St. Clare's Mercy Hospital, in St. John's, Newfoundland, Canada, introduced its pre-admission clinic in November 1993. The Same Day Admission program now consists of two components: the pre-admission clinic visit and the same day admission service. This study endeavoured to determine the effectiveness and the effects of a cost containment strategy on the quality of patient care of the Same Day Admission program, at St. Clare's Mercy Hospital. The objective of the study was to detect any problems in the process and quality of patient care and to make recommendations for continuous improvement. "Plan-Do-Check-Act" (PDCA) Cycle (Walton, 1986) was the conceptual framework used to focus the research. The research questions were placed in the "Check" phase of the PDCA Cycle. Conclusions were drawn about the efficiency, the effectiveness, and the quality of patient care for this program through a review of a) patient outcomes and clinical indicators, and b) patient and healthcare provider satisfaction with the program. The population for the patient interviews was patients who were prepared for surgery in the Pre-Admission Clinic (PAC) and admitted to hospital on the day of surgery during the first six months of the program. The population for the healthcare ...