Jeroen Bosch Hospital applies Patient Journey in Preoperative Screening

Patient guidance through the Patient Journey app

The Anaesthesiology Department of Jeroen Bosch Hospital (JBZ) in the Netherlands has implemented the Patient Journey app to make PreOperative Screening (POS) more efficient. By using the app, patients complete a triage questionnaire, which then guides them through the entire process leading up to surgery.

New approach to POS

The COVID-19 pandemic forced JBZ to react quickly. Elective surgeries had to be scaled down, but essential treatments for oncology, traumatology and obstetrics continued. This required a new approach to POS, which previously involved around 18,000 physical consultations annually. Prior to the app’s implementation, anaesthesiologists manually selected patients for either a physical or telephone consultation, which was time-consuming and inefficient, and resulted in unwanted variations in assessment.

Triage in the Patient Journey App

In order to streamline the process, the anaesthesiologists developed a triage algorithm (PACMAN) that was integrated into the Patient Journey App (PJA). Patients who are eligible for surgery are invited to use the PJA. One of the first steps in the app is completing a triage questionnaire. Based on the answers given there, the algorithm determines whether a telephone consultation is sufficient or whether a physical consultation is necessary. This system reduces the number of physical consultations by 70%, without increasing perioperative complications. The link with the EPR ensures that patients are automatically invited to the Patient Journey App when an operation is indicated. This connection is essential given the large number of patients using the app.

Benefits for patients, staff and hospital

Thanks to triage, 70% of patients can be safely screened over the telephone, leading to a significant reduction in the number of physical POS consultations. Because telephone consultations take less time than physical consultations, POS staff workload is also reduced. Better planning is also possible, because telephone screening is used for patients with fewer co-occurring disorders. This more efficient scheduling means fewer POS staff are needed to manage the patient flow, saving approximately EUR 100,000 per year. In other words, advance triage allows a 20% increase in capacity with the same number of staff. In addition, patients who qualify for a telephone consultation do not need to visit the hospital, which saves them time, money and avoids patients having to take time off work.

The implementation has resulted in a 20% capacity increase, saving EUR 100,000 while reducing the workload and increasing job satisfaction.

Patient guidance and experience

The app not only offers more efficient triage but also guides patients throughout the entire preoperative process. Patients are kept informed of important appointments via push notifications, such as fasting or pausing their use of blood thinners. The timing of the push notifications is linked to the operation date. If the date is changed unexpectedly, the timing of the push notifications is automatically adjusted accordingly. This continuous type of guidance ensures that patients are well prepared for their operation and reduces the number of last-minute cancellations.

Future

An extension of the algorithm is currently being developed. In addition to the triage outcome of a telephone or physical consultation, some patients will be suitable for full digital screening. For that particular patient group, the content of the Patient Journey App is automatically adjusted, and patients are shown information about the anaesthesia technique before informed consent is obtained. Fully digital screening will lead to a further efficiency boost in the POS.