What if Surgery Started On Time? A Look at the Overall Impact of Surgical First Case On Time Starts

2.50
Hdl Handle:
http://hdl.handle.net/10755/157055
Category:
Abstract
Type:
Presentation
Title:
What if Surgery Started On Time? A Look at the Overall Impact of Surgical First Case On Time Starts
Author(s):
Sunderland, Lorraine T.
Author Details:
Lorraine T. Sunderland, RN,CCRN,CPAN, Dublin Methodist Hospital, Dublin, Ohio, USA, email: LsunderL@ohiohealth.com
Abstract:
PURPOSE: Dublin Methodist HospitalÆs (DMH) surgical first case on time start delays produced a domino effect with customer service and operational efficiency. Health care providersÆ stress levels increased as a result of constant efforts to provide service recovery and work from behind. The impact of surgical delays and start time improvement measures on patient, family, surgeon, anesthesia provider, and associate satisfaction, as well as operational efficiency was examined. DESCRIPTION: DMH Surgical Services defines first case on time start as incision time. A daily log analysis of delay reasons for 100% of first cases included incomplete preadmission testing and missing orders and test results. Patients also arrived late in relation to inconsistent preoperative information provided by multiple sources. Late surgeons and anesthesia providers, and operating rooms with unavailable or missing instruments were also contributory delay factors. Delay reasons by health care provider were posted weekly with approval of the surgery oversight committee. The largest category included tardiness of surgeons at 80%û90%. Trends in delays were managed through associate performance management with strong emphasis on workflow process improvement/feedback. Process improvements in preoperative cycle time through information technology functionality/interoperability improvements, as well as preadmission testing chart completion at 72 hours via surgeon office. A reduction in block time for first case on time starts with greater than 3 delays /month directly attributed to the surgeon was also instituted. Additional surgeon block time allocation was also predicated on greater than 80% first case on time starts. EVALUATION/OUTCOMES:Through commitment and collaboration for patient safety, customer satisfaction, and surgical efficiency, DMH has achieved greater than 80% first case on time starts, from a baseline of 32%, and has led to Press Ganey customer satisfaction scores in the 90th percentile. Surgeon satisfaction in relation to fulfillment of operating room time is at the 99th percentile. Preoperative cycle time is averaging 34 minutes and preadmission chart completion is 76% for fiscal year 2010. Overall associate work life has been enhanced as evidenced by above national average associate opinion survey scores for job satisfaction at 5.1 with 6 as the highest possible score.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866
Conference Date:
2010
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
Washington, D.C., USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleWhat if Surgery Started On Time? A Look at the Overall Impact of Surgical First Case On Time Startsen_GB
dc.contributor.authorSunderland, Lorraine T.en_GB
dc.author.detailsLorraine T. Sunderland, RN,CCRN,CPAN, Dublin Methodist Hospital, Dublin, Ohio, USA, email: LsunderL@ohiohealth.comen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157055-
dc.description.abstractPURPOSE: Dublin Methodist HospitalÆs (DMH) surgical first case on time start delays produced a domino effect with customer service and operational efficiency. Health care providersÆ stress levels increased as a result of constant efforts to provide service recovery and work from behind. The impact of surgical delays and start time improvement measures on patient, family, surgeon, anesthesia provider, and associate satisfaction, as well as operational efficiency was examined. DESCRIPTION: DMH Surgical Services defines first case on time start as incision time. A daily log analysis of delay reasons for 100% of first cases included incomplete preadmission testing and missing orders and test results. Patients also arrived late in relation to inconsistent preoperative information provided by multiple sources. Late surgeons and anesthesia providers, and operating rooms with unavailable or missing instruments were also contributory delay factors. Delay reasons by health care provider were posted weekly with approval of the surgery oversight committee. The largest category included tardiness of surgeons at 80%û90%. Trends in delays were managed through associate performance management with strong emphasis on workflow process improvement/feedback. Process improvements in preoperative cycle time through information technology functionality/interoperability improvements, as well as preadmission testing chart completion at 72 hours via surgeon office. A reduction in block time for first case on time starts with greater than 3 delays /month directly attributed to the surgeon was also instituted. Additional surgeon block time allocation was also predicated on greater than 80% first case on time starts. EVALUATION/OUTCOMES:Through commitment and collaboration for patient safety, customer satisfaction, and surgical efficiency, DMH has achieved greater than 80% first case on time starts, from a baseline of 32%, and has led to Press Ganey customer satisfaction scores in the 90th percentile. Surgeon satisfaction in relation to fulfillment of operating room time is at the 99th percentile. Preoperative cycle time is averaging 34 minutes and preadmission chart completion is 76% for fiscal year 2010. Overall associate work life has been enhanced as evidenced by above national average associate opinion survey scores for job satisfaction at 5.1 with 6 as the highest possible score.en_GB
dc.date.available2011-10-26T19:22:54Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:22:54Z-
dc.identifier.citation2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866en_GB
dc.conference.date2010en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationWashington, D.C., USAen_GB
dc.identifier.citation2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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