Table 1.

Main differences of the pathway for elective surgery before and after redesign (based on Table2in Hovlid et al. 2012[13])

Time periode	Clinical pathway before redesign	Clinical pathway after redesign
Consultation at outpatient clinic	Medical pre-assessment done the day before surgery.	Surgeons and anesthesia personnel did conjointly establish a new routine that clarified the responsibilities and division of labor between them.
	Patients cleared for surgery were sent home without an appointment for surgery and without a medical pre-assessment.	Patients participated in planning the date of surgery and obtained the actual appointment while at the outpatient clinic.
Consultation at drop-in anesthesia outpatient clinic at day-surgery center	Not applicable	A new day-surgery center established within existing premises.
		Patients cleared for surgery proceeded directly to the laboratory for blood tests and medical pre-assessment at newly established drop-in anesthesia outpatient clinic at the day-surgery center.
		Surgeon’s dictated notes written immediately after consultation for anesthesia personnel to have information at hand during preoperative assessment.
Waiting for surgery	A letter with appointment for surgery was sent to the patient. Patients had no influence on appointment time.	Patients received a phone call from the hospital two days prior to surgery to ensure they were fit and ready.
	Limited planning across different surgical departments. Each department had their own surgery program that was not accessible on-line	One common electronic surgery planning system and the position of a coordinator for all surgical departments established.
Surgery	Patient showed up for pre-assessment the same day or one day in advance of the planned surgery.	All patients scheduled for elective surgery received at day-surgery center.
	Routines varied across departments.	Pre-surgery preparations standardized.
After surgery	Variation of discharge process in different department.	All day-surgery patients were discharged from the day-surgery center through new standardized routines.
	Discharge letter not always ready when the patient left.	Discharge letter written and given to the patient before discharge.