Problem

The increasing number of complex patients, multidisciplinary treatments and mandatory registrations causes an increased administrative burden on medical professionals.1 Recent research has shown that for each hour of direct patient care, a physician spends 2 hours on documentation in the electronic patient records (EPRs).2–5 This increased administrative burden limits the amount of time and attention of the physician for the patient, as well as the active participation of patients during the outpatient visit.3 4

More time can be spent on direct patient contact if the administrative burden during the outpatient visit is reduced, ultimately resulting in better quality of care and increased satisfaction for both patient and physician.

Situation

Approximately 60 000 new referred patients annually visit the outpatient department of our tertiary care hospital. The hospital introduced a new EPR in 2016, which greatly increased the administrative burden for physicians. This resulted in incomplete medical files that lacked mandatory data according to our hospital policy. One outpatient clinic developed a successful initiative in which physician aides completed parts of the EPR by means of a telephone conversation before the first visit. The positive experiences with this initiative led the divisional board of the outpatient clinics to introduce this method to all outpatient clinics. They commissioned the project ‘Well Prepared Is Half Done’, which was funded with an internal hospital fund. The aim of the project was to complete a basic set of medical data before the patient’s first visit, resulting in a reduction of the administrative burden for the physician.

Strategy

The project started in 2017 and used a plan, do, study, act (PDSA) approach to adapt and refine an initial dataset, process and telephone script (online supplementary data). The process applies …