Making the experience of elective surgery better

OBJECTIVE: Patient experience is one of the three pillars of quality in healthcare; improving it must be a key aim if we are to make the overall quality of the healthcare we provide better. METHODS: We devised a quality improvement project to improve the patient experience of elective surgery. We conducted surveys of patients and assessed their experience by using semistructured interviews and patient questionnaires. We gathered data about their overall satisfaction, fasting times and their communication with staff. We used this information to inform strategies aimed at improving patient experience. RESULTS: Our initial results showed that patients who had their operations later in the day were significantly less likely to report a positive experience. We found the main reasons for this were long waiting times, poor communication and prolonged fasting. We implemented changes over ‘Plan, Do, Study, Act’ cycles, including (1) staggering patient arrival times, (2) introducing the concept of the 'Golden Patient', (3) having a single point of contact on the day surgery unit to communicate between theatre staff and patients, (4) using the WHO checklist to finalise list order, and (5) altering patient information letters to include the possibility of a wait on the day of surgery. CONCLUSION: This project increased the percentage of patients reporting an ‘Excellent’ or ‘Good’ experience from 65% to 96%. In addition to improving our patients' experience, our project has also delivered shorter waiting times, better dissemination of information and fewer patients reporting hunger or thirst.