A procedure with a trail of paperwork
A patient with an ingrowing toenail sees the podiatrist, and partial nail avulsion is agreed. Then the admin begins. The patient needs to complete a medical history and medication questionnaire your clinic uses for surgery, read your pre-operative information, sign consent, arrange someone to take them home if your policy asks for it, and book a longer slot in the room you use for surgery. Afterwards there are dressing checks and a review until the podiatrist discharges them.
Each step is handled by a different person at a different time: the podiatrist, reception, sometimes a podiatry assistant. When one is missed, the day of surgery is where it shows.
Where the nail surgery pathway breaks
- Pre-operative forms are handed out on paper and come back on the day, incomplete.
- Information about aftercare and what to bring is given verbally and forgotten.
- Dressing check appointments are booked one at a time, so gaps appear in the chain.
- Surgery slots need the right room and the right practitioner, and are booked like any other appointment.
- Consent is signed on paper and filed separately from the electronic notes.
- Nobody can see, across all surgery patients, who is at which step.
The underlying problem is that the clinic system sees a set of unconnected appointments, when the clinic is really running a pathway.
What a broken pathway costs
Surgery postponed on the day because a form was not completed or a question was not asked. Theatre time lost. Patients who miss a dressing check because it was never booked. Anxious phone calls from patients who were not sure what to do. And a clinic that looks less organised than its clinical care deserves.
| Step | Common slip | Pathway step |
|---|---|---|
| Surgery agreed | Nothing happens until the patient calls | Pathway opened, next steps sent |
| Pre-op questions | Paper form on the day | Online form completed in advance, reviewed by the podiatrist |
| Information and consent | Verbal, then paper | Your leaflets sent, consent signed electronically |
| Surgery slot | Wrong room or length | Surgery appointment type with room rules |
| Dressing checks | Booked one at a time | Whole chain booked at once |
| Discharge | Not recorded as an outcome | Pathway closed with the date |
How we build the nail surgery pathway
- When the podiatrist agrees surgery, they open a pathway for the patient in a couple of clicks from the appointment.
- The patient is sent your pre-operative questionnaire and information leaflets by email or text, with a printed option for those who prefer paper.
- Completed answers go to the podiatrist to review. Any answer your clinical rules flag is highlighted for them, and the surgery is not confirmed until they have reviewed it.
- Consent is signed electronically at the point your clinic chooses, and stored with the patient's record in Cliniko, WriteUpp or your system.
- The surgery slot and the dressing checks your podiatrist specifies are booked together, in the right room and with the right length, so the chain is complete from the start.
- Reminders before surgery repeat your practical instructions, such as footwear and transport, in your own words.
- A pathway board shows every surgery patient, their current step and anything overdue.
Everything clinical, from suitability to aftercare instructions and discharge, is decided and written by your podiatrists. The system sends, books and tracks.
A surgery list that runs to plan
Patients arrive on surgery day with forms done and consent signed. Their dressing checks are already in the diary. Reception can see where every surgery patient is. Postponements for admin reasons become rare. And the podiatrist reviews pre-op answers at their desk in advance, not in a rush with the patient in the chair.
Is this your nail surgery process?
- Pre-op forms are completed on paper on the day of surgery.
- Dressing checks are booked one at a time.
- You have postponed surgery because something was missed in advance.
- Consent forms are filed separately from electronic notes.
- You could not list today which surgery patients are at which step.