Jayant Nick Pratap1, Anna M Varughese2, Patti Mercurio3, Terri Lynch3, Teresa Lonnemann4, Andrea Ellis3, John Rugg5, W Ray Stone5, Cindi Bedinghaus5. 1. Departments of Anesthesiology and Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio; and jayant.pratap@cchmc.org. 2. Departments of Anesthesiology and Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio; and. 3. Same Day Surgery. 4. Ambulatory Services and. 5. Perioperative Administration, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Abstract
BACKGROUND AND OBJECTIVES: Cancelation on the day of surgery (DoSC) represents a costly wastage of operating room (OR) time and causes inconvenience, emotional distress, and financial cost to families. A quality improvement project sought to reduce lost OR time due to cancelation. METHODS: Key drivers of the process included effective 2-way communication with families, compliance with fasting rules, and decision-making on patient illness before the day of surgery. A multidisciplinary team conducted serial tests of change addressing the various key drivers. Interventions were simplified, colorful, personalized preoperative instruction sheets and text-message reminders to caregivers' cellphones, as well as a defined institutional decision-making pathway to permit rescheduling before the day of surgery in case of patient illness concerns. After initial smaller-scale testing, the interventions were implemented across all patients and sites. Data were collected from the hospital information technology system and analyzed by using control charts and statistical process control methods. RESULTS: Mean OR time lost due to DoSC was decreased from a baseline of 5.7 to 3.6 hours/day in testing with a subset of surgical services at the hospital's base campus, and then from 6.6 hours to 5.5 hours/day when implemented across all services at both surgical sites. CONCLUSIONS: By applying quality improvement methods, significant reductions were made in time lost due to DoSC. The impact can be significant by improving institutional resource utilization.
BACKGROUND AND OBJECTIVES: Cancelation on the day of surgery (DoSC) represents a costly wastage of operating room (OR) time and causes inconvenience, emotional distress, and financial cost to families. A quality improvement project sought to reduce lost OR time due to cancelation. METHODS: Key drivers of the process included effective 2-way communication with families, compliance with fasting rules, and decision-making on patient illness before the day of surgery. A multidisciplinary team conducted serial tests of change addressing the various key drivers. Interventions were simplified, colorful, personalized preoperative instruction sheets and text-message reminders to caregivers' cellphones, as well as a defined institutional decision-making pathway to permit rescheduling before the day of surgery in case of patient illness concerns. After initial smaller-scale testing, the interventions were implemented across all patients and sites. Data were collected from the hospital information technology system and analyzed by using control charts and statistical process control methods. RESULTS: Mean OR time lost due to DoSC was decreased from a baseline of 5.7 to 3.6 hours/day in testing with a subset of surgical services at the hospital's base campus, and then from 6.6 hours to 5.5 hours/day when implemented across all services at both surgical sites. CONCLUSIONS: By applying quality improvement methods, significant reductions were made in time lost due to DoSC. The impact can be significant by improving institutional resource utilization.
Authors: Weng Hong Fun; Ee Hong Tan; Sondi Sararaks; Shakirah Md Sharif; Iqbal Ab Rahim; Suhana Jawahir; Vivien Han Ying Eow; Raoul Muhammad Yusof Sibert; Malindawati Mohd Fadzil; Siti Haniza Mahmud Journal: Healthcare (Basel) Date: 2021-05-31
Authors: Hung-Wen Tsai; Su-Wen Huang; Yin-Lurn Hung; Yu-Shan Hsu; Chien-Chung Huang Journal: Int J Environ Res Public Health Date: 2021-12-20 Impact factor: 3.390