Tillsonburg District Memorial Hospital Consolidated Outpatient Services

TDMH, as an organization, is committed to team management and shared leadership. It is in this spirit that the vision of consolidating all diagnostic outpatient services was realized. The consolidation achieved the dream of team members that patients could access all outpatient diagnostic services in one area, during one pre-scheduled visit and be served by a core group of well-trained, patient focused multi-skilled health-care professionals. Adjacent to the Emergency Room, this consolidation offers increased convenience for patients, nurses and physicians. Located at the outpatient entrance, this service also ensures easy access for all patients and facilitates convenient access to patient parking areas.

On September 24, 1996, a team was formed to further investigate Consolidated Outpatient Services. Their goal was “To provide outpatient Diagnostic and Treatment Services that are patient focused, efficient and effective, using a multi-skilled team approach.” All decisions were arrived at through a consensual process. The implementation team worked through collaboration with task forces involving all stakeholders on the following issues:

  • Centralized Scheduling process (Pre-scheduling all examinations)
  • File Storage and retrieval (Effective and efficient tracking and retrieval of films and reports)
  • Parking lot and traffic flow (Optimize access to parking and management of traffic flow)
  • Multi-skilling (Review of roles for all team members; keeping in mind the Regulated Health Professions Act)
  • Internal and External communication processes (Enhanced through collaboration with Stakeholders, Volunteers, Physicians and their office teams).

September 1, 1998, saw the opening of the new Consolidated Outpatient service area that is truly a one-stop visit for outpatients,served by multi-skilled team members utilizing a centralized scheduling process. The services included in this consolidated process include the following:

  • Bone Densitometry
  • Holter Monitoring
  • Mammography
  • Laboratory
  • Radiology
  • Respiratory
  • Stress Testing
  • Two (2) – Dimensional Echocardiography
  • Ultrasound

Patients no longer have to wander through the hospital looking for the area to have their tests done. There is no longer a need for patients to complete cumbersome duplications of paperwork and then wait endlessly for their procedures. The patient is able to call one number and pre-schedule numerous procedures, ordered by their physician, on a single passport requisition.

The Consolidated services has been in operation for over five years and there are several outcomes that have been realized from this process:

  • Ability to process a large number of patients within limited waiting room space, while effectively managing our human resource requirements. Volunteers assist patients upon arrival and facilitate the workflow by guiding patients to the designated area for their examination.
  • Pre-scheduled appointments have reduced the length of a patient visit by one half hour where patients require multiple tests.
  • Reduced number of trips a patient needs to make to the hospital by booking sequential tests.
  • Patient satisfaction surveys are very positive and indicate that the service consistently exceeds their expectations.
  • Follow-up with physician office staff have been very positive. Patients require only one requisition, instead of eight.
  • Turn-around time of reports to physician offices decreased as all results are reported collectively. This has improved turn-around time for the 15 per cent of total patient visits that require more than one service.
  • Physician receives more clinically useful results since diagnostic imaging and laboratory/cardiac testing results are now reported together.

Canadian Council of Accreditation commented on their survey:

“Both Diagnostic Imaging and Laboratory Services provide prompt, efficient, appropriate Diagnostic Services with a prioritization process in place in order to ensure prompt attention to immediate requests”.

This challenge was accomplished through collaboration and a team approach by participants from virtually all services in the hospital, physicians’ office staff and volunteers coming together and working toward a common goal. The Consolidated Outpatient Service is truly an example of a quality improvement project that has shown TDMH is patient-focused and responsive to the citizens of the Tri-County area. Cooperation and information-sharing with physicians’ offices has been enhanced and will continue to identify opportunities for improvement in patient services.