• Gitara M Edward, Benedikt Preckel, Branka S Martijn, Frans J Oort, Hanneke C J M de Haes, and Markus W Hollmann.
• Department of Anaesthesiology, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands.
• Eur J Anaesthesiol. 2010 Feb 1;27(2):209-13.

Background And ObjectiveLong waiting times are a problem often encountered at the preoperative assessment clinic (PAC). To tackle this problem, we redesigned our appointment system using a multifactor approach. Waiting times and patients' experiences before and after implementation of the new appointment system were compared.MethodsDuring 3 weeks, patient flow times were measured at the PAC. These were used to calculate the procedure time of the nurse and physician, and the patient's waiting time. Patients who visited the PAC received the Patient Experiences with the Preoperative Assessment Clinic questionnaire to measure their experiences. Waiting times and patients' experiences before and after implementation of the new appointment system were compared.ResultsAfter implementation of the new appointment system, mean total waiting time was reduced from 26 (SD 23) min to 16 (15) min (P < 0.001). Thirty per cent of the patients were late for their appointment. On average, physicians were 21 (10) min late for their first appointment. The questionnaire was sent to 476 patients (response 68%). On a 0-100 scale, patients' experiences with waiting time improved from 49 (19) to 52 (18) and patients' mean overall appraisal of the PAC increased from 78 (16) to 81 (14) (P < 0.05).ConclusionThe new appointment system reduced the waiting time at the PAC, and patients' experiences were more positive after implementation of the new system. All efforts should be made to avoid unpunctuality from physicians and patients.

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