Date of Award

Spring 4-4-2023

Document Type

Scholarly Project

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Sheri Jacobson, PhD, RN

Second Advisor

Robin Gasparini, DNP, APRN, ACNS-BC

Abstract

Practice Problem: Candidacy for transplant evaluation is a complex and lengthy evaluation process. Delays in National Organ Registry have significant unfavorable impacts on patient outcomes as 22 people a day die awaiting a lifesaving treatment. Operational efficiencies can improve the pre-transplant evaluation period and significantly improve patient outcomes.

PICOT: In an outpatient transplant clinic (P), will leveraging an evidence-based scheduling template (I) compared to the current practice of first available appointment (C) reduce the evaluation period by 66% from a 3–4-week evaluation to a 1-week evaluation resulting in expedited listing on the National Organ Registry (O), when applied over a 10-week period (T)?

Evidence: Electronic scheduling templates are evidenced to improve access, workflow efficiencies, and reduce patient wait times by 25% (Suss et al., 2017). Leveraging a value stream mapping tool, gaps in process time can be identified while improving quality outcomes

Intervention: An evidence-based scheduling template was applied to measure impact on access availability to appointments for pre-liver transplant patients. Pre-and-post intervention data measured the impact of the scheduling process efficiency, process waste, and total lead time.

Outcome: The scheduling template was found to have a statistically significant impact on scheduling efficiency, resulting in a 65.2% (p<.001) reduction in total lead time, reducing evaluation days from an average of 22.71 days (545.04 hours) to an average of 7.9 days (189.6 hours).

Conclusion: The new scheduling template improved appointment access and expedited patient’s National Organ Registry by 15 days. Operational efficiencies gained by use of an electronic scheduling template not only have favorable impacts to patient outcomes, but also on organizational costs through improved workflows, and a favorable staff and patient experience.

Comments

Scholarly project submitted to the University of St. Augustine for Health Sciences in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice.

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

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