Patient Mechanism Before Operating

Out Patient Departement (OPD) Medical dan Surgical

Patient must book before admitting OPD. Patient needs for OPD appointment. Doctor can determine whether patient needs for operation or not and discussed with patient and his family. Patient will sign a consent form, this will be done in OPD or at Pre Admission Clinic/PAC.

DOSA/Day of Surgery Admission

Before the patient enters the Operating Theatre/OT, patient enters to DOSA
Data may be entered into a computer that provides a print out of admitting Operating Theatre sheet that was held by nurse including : full legal name, URN, DOB (date of birth}, Age, Admit, Type of Anesthetic, Ward, Start, Kind of Operation, Surgeon, Anaesthetist. After this, patient receives an identification bracelet, and changes his clothes and then checked all of the forms from Pre Admission Clinic. In this room patient has to wait for 5 minutes to 30 minutes.

Before the operation
Patient will attend Pre Admission Clinic where patient will reviewed by Nursing/RN, Medical and Allied Health Staff. They will obtain a medical/nursing history and arrange for any necessary tests (laboratory, ECG, X-ray). Patient will sign a Consent form, this will be done in OPD or at the Pre Admission Clinic. They will also discuss patient’s pre and post operative needs and discharge needs. If patient has any questions regarding his operation don’t hesitate to ask them.

The anaesthetist will discuss patient’s type of anesthetic, pain relief and give instructions regarding fasting. Patient is admitted the day of his surgery. Occasionally patient may be admitted the day before. If patient is able to be admitted later than 07.00 this will be indicated to patient at the Pre Admission Clinic or By the DOSA Nursing Staff the afternoon prior to patient’s admission

The Queen Elizabeth Hospital/Australia

Patient will attend
* For acute Case:Emergency--> Emergency Department--> Operating Theatre--> Ward
• For Elective: OPD-->PAC--> Go Home-->DOSA--> OT--> Ward
• OPD or Private Doctor--> Day Surgery --> Home Same Days


Public Hospital/Indonesia

Patient will attend
• For Elective surgery: OPD--> Go Home--> Ward--> OT--> Ward
• For Acute Case: Emergency-->Emergency Department/IGD--> OT--> Ward


Comparison between TQEH/Australia and Public Hospital/Indonesia

In Australia/TQEH

- Health teaching before and after operation is good
- Family are involved to obtain information about pre and post operation
- With this pathway the possibilities the patient will be miss operated is small, because patient had been checked carefully
- Patient does not wait long for surgery
- In Australia they have Computerized System in Operating Theatre for Documentation.

In Indonesia/Public Hospital
- Nurses rarely give health teaching before and after operation
- Patient have to wait for along time for surgery for 2 weeks to 3 months, and cause the patient feel distress, angry, bored and ultimately must pay more money with the increase of their day of stay in the hospital
- Public Hospital don’t have room like DOSA as in TQEH in Australia to check patient and all of the forms carefully before entering the operating room,
- In Indonesia we don’t have Computerized System in the Operating Theatre for Documentation

Efy Afifah,
Adelaide, 2000