An Evolutionary Change in First Case on Time Starts Using Perioperative Process Improvement, Communication and Enhanced Data Integrity

Abstract

Background: First Case on Time Starts (FOTS) are an important Operating Room performance metric. The study aim is to show how implementation of process improvement (PI) solutions and an electronic health record (EHR) led to a progressive, signifi cant, and sustainable improvement in FOTS. scheduled fi rst cases were evaluated. Signifi cance was set at p<0.05.Results: FOTS were 12% in 2006. An OR Collaborative Redesign, implementation of a preoperative clinic and a change the preoperative phone call increased FOTS to 32% by early 2009. In 2009, an EHR was implemented. The EHR, its ability to identify specifi c accountability for delay (surgeon, anesthesiologist, and nurse, patient, other) and improved data integrity, increased FOTS to 60% by 2012. Using enhanced communication methods such as real time communication to staff, and data socialization, FOTS further improved to 80% by 2014. Conclusion:A series of process improvement solutions and an EHR implementation resulted in sustainable improvement. With tactics such as sharing the data promptly, pinpointing and addressing outliers, and aligning performance to annual goals, our MOR experienced a greater than six-fold improvement in FOTS.

Assessing the Impact of Lean Healthcare on Inpatient Care: A Systematic Review

“…The perioperative process includes the preoperative, operating room, and the postoperative departments, all of which have to run like a well-oiled machine to improve performance and achieve positive outcomes [ 112 ]. In this regard, preoperative throughput is an important element in achieving the perioperative goals for the first case’s on-time start (OTS) [ 105 , 113 , 114 ]. In this research, all seven studies improved their on-start times after LH intervention.…”

Faktor Yang Menyebabkan Keterlambatan Mulai Operasi Pertama Pasien Elektif: Literatur Review

“…Studi yang dilakukan oleh Robert mengungkapkan bahwa 150 dari 262 operasi pertama pasien elektif mengalami keterlambatan (57%). Alasan keterlambatan menunjukkan bahwa dokter bedah menyumbang 30% dari penyebab keterlambatan, ahli anestesi 17%, dan perawat 10% (Robert P, Foglia, Juan ER, 2017).…”

“…Selain dokter operator, dokter anestesi juga berpengaruh dalam ketepatan waktu dimulai operasi pertama. Menurut Robert, dokter anestesi menyebabkan 17% dari penyebab keterlambatan (Robert P, Foglia, Juan ER, 2017) Keterlambatan ini dokter bedah dan dokter anestesi dalam menjalankan tugasnya menunjukkan kurangnya komitmen dalam bekerja. Komitmen adalah keterikatan untuk memenuhi kewajiban.…”