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Florida Surgical Center in Gainesville is saving 20 minutes per patient by using a documentation pathway a critical pathway that dictates patient care and serves as a documentation tool. (See pathway, pp. 142-145.)
Data collection begins when the patient is seen preoperatively, and that information is transferred to the intraoperative and postoperative staff with the form, says Linda Pittman, NPC, CNOR, clinical coordinator. Documentation begins when the patients call for their arrival time and ends when they receive the follow-up telephone call at home.
"In a big teaching facility, there are many forms," she says. "This consolidates a lot of that paperwork nightmare we had to deal with in the past."
"Before, we had five different pieces of paper for it," says Gail Avigne, RN, CNOR, OR nurse manager. "It’s a timesaver because you’re not having to duplicate work or look for different pieces of paper."
Florida Surgical Center has developed other clinical paths to standardize care and supplies, avoid duplication of documents, and save costs. These pathways will be profiled in next month’s issue of Same-Day Surgery.
As an example of how the documentation path avoids duplication of work, consider that the psychosocial assessment was performed in pre-op and in the OR. "Now we do one," Avigne says. Focus cues also were duplicated. "That’s why we called it a pathway," she says. "It’s a mechanism of doing care, but you’re documenting at the same time." The documentation piece is critical. "When you start a pathway, you come up with great ideas. The trick is to make sure you’re doing them. By documenting, we know we are."
The proof is in the patient satisfaction, she says. Patients used to complain, "Someone just asked me that." With the new forms, it appears staff are talking to each other about the patients. "We can say, I see you’re allergic to . . . ,’ instead of asking the same questions over and over," Avigne says.
Having the disciplines work side by side to put their documentation together was the fun part of the process, she says. "Someone would say, I’m asking that. Why not change the wording so we aren’t asking that again.’ It sounds simple. Pathways usually are."