Improving on-time start for iMRI neurosurgeries

Abstract

Background:In the Singapore General Hospital, intraoperative MRI (iMRI) neurosurgery is a multi-disciplinary process that involves staff from multiple departments. However, a baseline analysis showed that only 10.5% of iMRI neurosurgeries start on time, resulting in unnecessary waste of resources. The project aimed to improve the percentage of on-time start iMRI neurosurgeries to 100% within nine months.Materials and Methods:Clinical Practice Improvement methodology was used. The project involves four phases: Diagnostic, in which a baseline analysis is conducted; Intervention, in which problem areas are identified; Implementation, in which potential solutions are implemented; and sustaining, in which strategies to sustain gains are discussed.Results:The percentage of on-time start cases gradually increased to 100% in eight months, and was sustained above 85% in the following five months.Conclusion:This project serves as a successful demonstration of how quality improvement can be effected in a complex, multidisciplinary workflow, which is the norm for many hospital procedures.

Initial experience of using high field strength intraoperative MRI for neurosurgical procedures

“…Ensuring the patient is acquainted with the operative premises and performing preoperative MRI 1 day prior to surgery helps to improve patient compliance and relieves preoperative anticipation. Similar to our observations, Ghadiali et al [13] extensively evaluated the technical and rate limiting factors associated with delays in IOMRI. Implementing clinical practice improvement methodology, they observed an 85% improvement in the on-time start of neurosurgical procedures.…”