RESUMO
In 2008, Mayo Clinic in Jacksonville, Florida, developed the preoperative evaluation (POE) clinic under the department of anesthesiology to provide preoperative history and physical examination, and medical optimization. Over time, the POE clinic expanded to accommodate more than 90% of surgical patients, outgrowing the initial practice model. The increased patient volume with shortened turnaround times bottlenecked patient access. A multidisciplinary quality improvement team used Define, Measure, Analyze, Improve, and Control methodology to understand the issues, test potential solutions, and develop sustainable processes. With progressive Plan-Do-Study-Act cycles, it moved from small internal tests of change to implementation throughout the institution. Patient access improved by 14% (P < .001) and triage efficiency by 30% (P < .001). These elements led to a 14% improvement in operating margin and a 24% improvement in staff satisfaction. Sustainability was ensured with an accessible dashboard of performance indicators.
