Elizabeth van Veen-Berkx1, Justin Bitter2, Geert Kazemier3, Gert J Scheffer4, Hein G Gooszen5. 1. Department of Operating Rooms, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands. Electronic address: e.berkx@erasmusmc.nl. 2. Department of Operating Rooms, Bernhoven Hospital Uden, Uden, The Netherlands. 3. Department of Surgery, VU University Medical Center Amsterdam, Amsterdam, The Netherlands. 4. Department of Anesthesiology, Pain and Palliative Care, Radboud University Medical Center Nijmegen, The Netherlands. 5. Department of Operating Rooms/Evidence Based Surgery, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands.
Abstract
BACKGROUND: Poor inter-professional collaboration might negatively influence adequate planning of operative procedures. Interventions capable of improving inter-professional collaboration will positively impact professional practice and health care outcomes. Radboud University Medical Center (UMC) redesigned their operating room (OR) scheduling method by implementing cross-functional teams (CFTs). In this center, positive effects of CFTs were already demonstrated in a mono-center study. This study aims to confirm these effects by comparing the Radboud data with data from 6 other similar centers using a nationwide OR benchmark collaborative. STUDY DESIGN: The effect of CFTs was measured by the performance indicator "raw utilization." The Kruskal-Wallis one-way ANOVA was applied to compare OR performance among all 7 centers. The Wilcoxon-Mann-Whitney test was used to determine differences in OR performance between Radboud UMC and the control group. RESULTS: Operating room performance differed significantly among all 7 centers (p<0.0005). Radboud UMC demonstrated the highest median raw utilization of 94% vs 85% in the control group (p<0.0005). Box-and-whisker plots validated the reduced variation during the years, indicating an organizational learning effect. Therefore, not only a better performance than the control group, but also a gradual improvement of this performance during the years. CONCLUSIONS: This study shows that multidisciplinary collaboration in CFTs during the perioperative phase has a positive influence on OR scheduling and use of OR time. Other national databases considering mortality rates also support the idea that introducing CFTs is not only an important condition for improving OR performance, but also for improving quality of care.
BACKGROUND: Poor inter-professional collaboration might negatively influence adequate planning of operative procedures. Interventions capable of improving inter-professional collaboration will positively impact professional practice and health care outcomes. Radboud University Medical Center (UMC) redesigned their operating room (OR) scheduling method by implementing cross-functional teams (CFTs). In this center, positive effects of CFTs were already demonstrated in a mono-center study. This study aims to confirm these effects by comparing the Radboud data with data from 6 other similar centers using a nationwide OR benchmark collaborative. STUDY DESIGN: The effect of CFTs was measured by the performance indicator "raw utilization." The Kruskal-Wallis one-way ANOVA was applied to compare OR performance among all 7 centers. The Wilcoxon-Mann-Whitney test was used to determine differences in OR performance between Radboud UMC and the control group. RESULTS: Operating room performance differed significantly among all 7 centers (p<0.0005). Radboud UMC demonstrated the highest median raw utilization of 94% vs 85% in the control group (p<0.0005). Box-and-whisker plots validated the reduced variation during the years, indicating an organizational learning effect. Therefore, not only a better performance than the control group, but also a gradual improvement of this performance during the years. CONCLUSIONS: This study shows that multidisciplinary collaboration in CFTs during the perioperative phase has a positive influence on OR scheduling and use of OR time. Other national databases considering mortality rates also support the idea that introducing CFTs is not only an important condition for improving OR performance, but also for improving quality of care.
Authors: Daisy Goodman; Greg Ogrinc; Louise Davies; G Ross Baker; Jane Barnsteiner; Tina C Foster; Kari Gali; Joanne Hilden; Leora Horwitz; Heather C Kaplan; Jerome Leis; John C Matulis; Susan Michie; Rebecca Miltner; Julia Neily; William A Nelson; Matthew Niedner; Brant Oliver; Lori Rutman; Richard Thomson; Johan Thor Journal: BMJ Qual Saf Date: 2016-04-13 Impact factor: 7.035