Redesign of the pre-operative process : a quantitative modeling and optimization study on process improvements in Isala klinieken, Zwolle

Like many other hospitals, Isala klinieken organizes pre-operative screening for surgical patients in an outpatient clinic (PAC). Isala klinieken operates at three locations: two hospitals, “Sophia” and “Weezenlanden”, and one field facility in Kampen. At each location a preoperative screening clinic is present. The screening process involves a visit to the secretary, doctor’s assistant, anesthesiologist, and pre-anesthesia nurse. The pre-anesthesia evaluation clinic receives inflows from almost all specialty departments and is perceived as a potential bottleneck in the pre-operative process, influencing the overall hospital efficiency. Most patients get a screening appointment at the specialty department, and are screened on another day. Increasing waiting times, long access times, non-screened patients, and increasing workload, demands for an improvement in the design and control of the pre-operative process.