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AAPS 85th Annual Meeting
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Same Day Surgery: Streamlining the Care Experience for Patients Undergoing Treatment for Skin Cancer in a Large Integrated Delivery System
Berry E. Morton, M.D., Royal Gerow, M.D., Todd A. Morton, M.D., John Cochran, Jr., M.D..
Colorado Permanente Medical Group, Denver, CO, USA.

PURPOSE: In 1998, our four surgeon plastic surgery department was overwhelmed with referrals for head and neck skin cancer margin control excision and reconstruction. The patient experienced an average over 90 days from referral to treament. This work was initiated to improve the patient care service experience.
METHODS: The entire care process was analyzed. The traditional preoperative consultative appointment was challenged and eliminated. The redesigned process allowed referring physicians to send patients directly to surgery. The system included dedicated physician time, block procedure room scheduling, dedicated staff and pathology support and an overall streamlined patient experience. The surgeon meets, examines, counsels, excises, examines frozen section margins, and reconstructs all with the first appointment; hence the name - Same Day Surgery.
RESULTS: Over 1500 cases have been done using this system of care. There is strong measured satisfaction from patients, surgeons, referring physicians, and staff. Clinical quality is excellent. Overall departmental performance has achieved dramatically improved access for all types of referral.
CONCLUSION: Many of our systems of care have been designed with a physician focus. Systems should be designed with a patient focus.

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