Nationally Ranked Hospital Streamlines OR Processes

Regular delays in operating room (OR) start times often cue the need to address non-value-added work flow activities and process variations. While these delays will certainly reduce operating room capacity, the greatest risk is the unpredictable systemic variations that may impact delivery of the best possible clinical outcomes.

A nationally ranked pediatric hospital began an internal ear, nose, and throat (ENT) Canned Case Time Study with internal stakeholders. The study was not yielding the expected results and TechSolve was hired to assist.

    Project: Working collaboratively, the team defined the project objectives:
  • Streamline processes to deliver the best possible clinical outcomes
  • Enhance the patient and caregiver experience with on-time starts
  • Reduce PET OR delays and increase operating room capacity
  • Develop improved PET preoperative workflow and reduce process variation

TechSolve partnered with internal resources to quickly evaluate the current processes and develop high level process maps to identify “just-do-it” and “rapid test of change”
improvements. These improvements, although varied in complexity (requiring surgeons to always mark site before consulting parents of previous patient; site marking before 7:20 a.m. with patient pick-up at 7:20 a.m. for a 7:30 a.m. start; scheduled time for OR briefing;
scheduled time for medical decision), were implemented over a four-week period but tracked for many months.

Results: The improvements were piloted across all ENT surgeries with goals focused on stopping the rapidly declining on-time-start results of the previous two years. The processes were more patient-centric with clearly defined timed-start processes, with reduced variation, and more efficient workflow. ENT cases start-time improved 17.5% in Q2 FY08 to an average of 87% up from a baseline of 74%. These results are expected to continue to improve as the staff continues to self-monitor and improve with a continuous improvement mind-set.