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ULS Santo António (Santo António Local Health Unit)

Streamlining surgeries by automating pre and post-operative processes

Hospitals and patients face longer waiting times due to inefficient surgical processes and obstacles to seamless care navigation. In this success story, the clinical team from CICA – Integrated Center of Ambulatory Surgery - at Santo António Local Health Unit shares how digitizing patient journeys and automating pre-anesthetic assessments and post-surgical follow-ups have transformed care - making it safer, more efficient, and more patient-centered.

~200

work hours saved (4 months project)

-50%

nursing teams’ time spent on follow-up

~85%

patient engagement

Hospital Insights:

  • +26,000 Patients undergoing surgery (per year)
  • +32,000 Surgeries performed (per year)
Long waiting lists for elective surgeries are a constant challenge for patients and a major concern for hospital administrators. For patients, delays mean prolonged pain and disability, postponing the benefits of treatment. These delays can also have serious financial implications for hospitals, affecting operational efficiency and resource allocation.
The underlying causes of surgical wait times are diverse. A key factor is the lack of resources, including insufficient staff - who are often burdened with tasks that do not match their qualifications - and limited equipment availability. Additionally, inefficiencies and barriers in care navigation lead to higher patient no-show rates and intraoperative cancellations, further exacerbating waiting lists.

Problem

  • High rates of no-shows and surgical cancellations due to poor patient navigation;
  • Limited patient safety during early discharge;
  • Inability to adapt perioperative workflows based on individual patient risk.

Project Goals

  • Standardize perioperative assessments with structured, evidence-based pathways;
  • Streamline preoperative processes to reduce anesthesiologists’ time spent on low-risk patients;
  • Shorten appointment duration and minimize time spent on documentation throughout the perioperative journey;
  • Enhance team confidence and patient safety at discharge, ensuring early identification of red flags post-hospitalization;
  • Reduce the need for hospital staff in follow-up monitoring.
The perioperative journey was implemented. It serves as a vital link between the clinical care team and the patient. Functioning as an extension of healthcare services, it aims to strengthen patient engagement, conduct essential evaluations, and accommodate both the patient’s medical needs and personal schedule.

Optimized anesthetic risk pre-assessment to enhance team efficiency and improve patient readiness.

Our solution automatically determines a patient’s overall risk level by combining the ASA classification (I–IV), based on a patient survey, with the surgical risk. This enables a comprehensive individual risk assessment. Based on the results, additional diagnostic or therapeutic measures are recommended, and the necessity of an in-person or remote anesthetic consultation is evaluated. Low-risk patients are fast-tracked to surgery, allowing anesthetic teams to focus on more complex cases.

One of our primary concerns is the risk of missed scheduling or patient no-shows on the day of surgery. An even greater challenge arises when a patient arrives at the hospital as scheduled, but the surgery cannot proceed. This implementation helps mitigate these risks, ensuring a smoother surgical workflow and preventing such critical disruptions.

Duarte Rego, MD

Vascular Surgeon

The primary goals of this project are to prevent last-minute surgical cancellations, patient no-shows, and hospital readmissions. Additionally, it aims to ensure patient safety throughout the clinical journey both before and after surgery.

Maria do Sameiro Caetano Pereira, MD

Director at CICA (Ambulatory Surgery Integrated Center)

Patient empowerment and improved adherence to care plans

Surgery can be an overwhelming experience, but educating patients about key aspects - such as the procedure itself, anesthesia, intraoperative care, and postoperative pain management - helps reduce anxiety, enhance compliance with pre-surgical guidelines, and support faster recovery. This leads to better surgical outcomes and fewer no-shows. UpHill’s solution provides personalized, clinically validated information tailored to each patient’s condition and perioperative journey, ensuring they feel informed, prepared, and confident at every stage of the process.

This approach will enhance the patient’s sense of safety, which in turn improves their health literacy. By managing every aspect of the process, we will also achieve a key goal: increasing the complexity of patients eligible for ambulatory surgery.

Sílvia Neves, MD

General Surgeon

Automating Follow-Up for Early Detection of Exacerbations

Effective post-surgical monitoring enhances patient safety and gives physicians greater confidence in discharge decisions. UpHill’s automated post-discharge follow-up system utilizes clinically validated questionnaires to track patient recovery in real-time. By continuously monitoring progress, this system enables the early detection of warning signs, ensuring timely interventions and improved patient outcomes.

Post-operative follow-ups no longer require human intervention. Instead, a safety triage system ensures that no issues are overlooked, applying a clinical perspective when necessary to maintain patient safety and care quality.

Duarte Rego, MD

Vascular Surgeon

Our goal is to provide those who seek our help with the highest level of care and attention. For ambulatory surgery, this means expanding care at home while ensuring we maintain our close support and attention throughout the process.

Daniela Matos

Specialist Nurse in Management Roles

Solution details and highlights

  • A care pathway based on the best evidence, customized to the local context.
  • An omnichannel approach to collect patient information through familiar channels (SMS, phone calls, and email).
  • No invasive devices or medical procedures.
  • Use of validated and automated questionnaires.
  • Smart use of collected data to update the patient's status.
  • Automatic patient risk stratification.
  • Interoperability capabilities to connect different systems and reduce task repetition.
  • Automatic alerts to notify healthcare teams of signs of patient decompensation.
  • Dashboard with aggregated data for monitoring patient journeys.
  • Compliance with GDPR and certifications in ISO27001 and ISO13485.

Disclaimer

This data is specific for this use-case in this institution and is presented as an example of how UpHill Route indirectly improves patient management processes in a context in which clinical decision support systems are used. The institution itself collected data. UpHill Route does not claim any direct clinical benefit leading to readmission reduction, access increase, or unnecessary appointment reduction.

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