[AVBC 2025] Implementing Advanced Practice Nurse-led Site Marking in a Same-day Procedure Setting
Care Process & Redesign
Workforce Transformation
Appropriate & Value-based Care Conference
National University Health System
27 November 2025
The aim of the study is to reduce procedure delays by implementing Advanced Practice Nurse (APN)-led site marking at NCIS. APN-led site marking results in the elimination of site marking-related procedural delays and enhances operational efficiency.
Year Submitted: 2025
Published Date: 27 November 2025
Tags: Care Process ＆ Redesign, Quality Improvement, Workflow Redesign, Productivity, Cost Saving, Time Saving, Job Effectiveness, Workforce Transformation, Job Redesign, Upskilling
About this Content
Aims
The aim of the study is to reduce procedure delays by implementing Advanced Practice Nurse (APN)-led site marking at NCIS Short Stay Ward.
Background
Traditionally, pre-procedure site marking is performed only by physicians. However, physician unavailability has led to procedural delays and cancellations.
Methods
The study collected data on procedure cancellations, delays, and revenue loss. It used historical data from April to November 2024 and prospective data from December 2024 to July 2025. Stakeholder surveys on satisfaction and confidence were also conducted.
Results
The implementation of APN-led site marking resulted in the elimination of site marking-related procedural delays, enhanced manpower utilization, and operational efficiency. There was a $9600 revenue loss from cancellations before implementation, which was reduced to $0 post-implementation. The study also achieved 100% confidence from physicians and 100% satisfaction from nurses.
Conclusion
APN-led site marking results in the elimination of site marking-related procedural delays and enhances operational efficiency. It can be considered in non-cancer clinical settings for optimizing patient care and processes.
Lessons Learnt
The study demonstrated that APN-led site marking can be effectively implemented to improve workflow efficiency and reduce procedural disruptions.
Keywords
Site marking, APN, operational efficiency, procedure delays, cost savings
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National University Health System |
Organization(s) Involved | National University Cancer Institute, Singapore |
Platform(s) | Appropriate & Value-based Care Conference |
Healthcare Professional Group(s) | Nursing |
Applicable Specialty or Discipline | Oncology |
Project Lead(s) | Lee Ang Yun |
Project Member(s) | Grace Cham |
Connect with this contributor!
Lee Ang Yun - lee_ang_yun@nuhs.edu.sg