The application of quality improvement methodologies in surgery

Abstract

Quality improvement (QI) practices were originally developed in the manufacturing industry to reduce unnecessary steps in a process, minimize error, and provide maximum benefit to the consumer. QI is defined as a formal approach to the analysis of performance and systemic efforts to improve it. QI methodologies have been adopted by industries outside manufacturing, including healthcare. In the healthcare environment, performance consists of many factors including patient safety, clinical results, and system efficiency. Given the publicly funded, limited resource environment in which the Canadian healthcare system operates, the practice of delivering safe, quality healthcare in an efficient and cost-effective manner is an important factor in promoting the economic viability and sustainability of the system. Surgical practice has been identified as an area in which QI methodologies can be applied, given its resource intensive nature and highly regulated environment. Current research supports the use of QI in surgery, with interventions showing improvements in non-operative time, on-time starts, and operating room patient volume. Limitations to the application of QI include the heterogeneity of interventions and variability in terms of procedures and patient factors. Further high-quality studies are required to support evidence-based applications of QI in the surgical setting as well as the greater healthcare environment.

Quality improvement in hospitals' surgery-related processes: A systematic review

“…Using QI models in health care creates a systematic approach to problem solving, help providers to improve the process, facilitate teamwork, and create a clear plan to communicate at any time and also offer a set of tools, a powerful way to thinking about how to transform clinical operations to achieve better results for patients and healthcare teams and a framework for healthcare professionals to follow in implementing process improvement changes (15,16). Given the economic climate both nationally and internationally, QI models in surgery constitute an emerging practice that should be considered at all levels of healthcare organizations, as they contribute to the financial viability and sustainability of the healthcare systems for future generations (17).…”