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‘Golden Patient’: A quality improvement project aiming to improve trauma theatre efficiency in the Royal Gwent Hospital
The efficiency of trauma lists when compared with elective orthopaedic lists is a frustration of many orthopaedic departments. At the Royal Gwent Hospital, late start times affecting total operating capacity of the trauma list were recognised as a problem within the department. The design team aimed...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440604/ https://www.ncbi.nlm.nih.gov/pubmed/30997419 http://dx.doi.org/10.1136/bmjoq-2018-000515 |
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author | Key, Thomas Reid, Gavin Vannet, Nicola Lloyd, John Burckett-St. Laurent, David |
author_facet | Key, Thomas Reid, Gavin Vannet, Nicola Lloyd, John Burckett-St. Laurent, David |
author_sort | Key, Thomas |
collection | PubMed |
description | The efficiency of trauma lists when compared with elective orthopaedic lists is a frustration of many orthopaedic departments. At the Royal Gwent Hospital, late start times affecting total operating capacity of the trauma list were recognised as a problem within the department. The design team aimed to improve the start time of the list with the introduction of the ‘golden patient’ initiative. A protocol was agreed between the orthopaedic, anaesthetic and theatre staff where a ‘golden patient’ was selected for preoperative anaesthetic assessment by 14:00 the day before surgery and sent for at 08:15 as the first case on the trauma list. Baseline data was collected over a month. Two Plan-Do-Study-Act (PDSA) cycles were completed, one on the month the ‘golden patient’ initiative was implemented and one 4 months after the change. All data was collected from the Operating Room Management Information Service theatre system for the trauma theatre at the Royal Gwent Hospital. Results demonstrated significant improvement in patient arrival time in the theatre suite; PDSA1 by 33 min (p≤0.001) and PDSA2 by 29 min (p≤0.001) and an earlier start of the first procedure; PDSA1 by 19 min (p=0.018) and PDSA2 by 26 min (p≤0.001). There was also increased mean operating time per list (PDSA1 +16 min and PDSA2 +33 min), increased total case number (PDSA1 +20 cases and PDSA2 +36 cases) and reduced cancellations (PDSA1 −2 cases and PDSA −5 cases) compared with our baseline data. We demonstrated that the introduction of a ‘golden patient’ to the trauma theatre list improved the start time and overall operating capacity for the trauma list. Continuing this project, we plan to introduce assessment of all patients with fractured neck of femur in a similar way to the ‘golden patient’ to continue improving trauma theatre efficiency and reduce case cancellations. |
format | Online Article Text |
id | pubmed-6440604 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-64406042019-04-17 ‘Golden Patient’: A quality improvement project aiming to improve trauma theatre efficiency in the Royal Gwent Hospital Key, Thomas Reid, Gavin Vannet, Nicola Lloyd, John Burckett-St. Laurent, David BMJ Open Qual BMJ Quality Improvement report The efficiency of trauma lists when compared with elective orthopaedic lists is a frustration of many orthopaedic departments. At the Royal Gwent Hospital, late start times affecting total operating capacity of the trauma list were recognised as a problem within the department. The design team aimed to improve the start time of the list with the introduction of the ‘golden patient’ initiative. A protocol was agreed between the orthopaedic, anaesthetic and theatre staff where a ‘golden patient’ was selected for preoperative anaesthetic assessment by 14:00 the day before surgery and sent for at 08:15 as the first case on the trauma list. Baseline data was collected over a month. Two Plan-Do-Study-Act (PDSA) cycles were completed, one on the month the ‘golden patient’ initiative was implemented and one 4 months after the change. All data was collected from the Operating Room Management Information Service theatre system for the trauma theatre at the Royal Gwent Hospital. Results demonstrated significant improvement in patient arrival time in the theatre suite; PDSA1 by 33 min (p≤0.001) and PDSA2 by 29 min (p≤0.001) and an earlier start of the first procedure; PDSA1 by 19 min (p=0.018) and PDSA2 by 26 min (p≤0.001). There was also increased mean operating time per list (PDSA1 +16 min and PDSA2 +33 min), increased total case number (PDSA1 +20 cases and PDSA2 +36 cases) and reduced cancellations (PDSA1 −2 cases and PDSA −5 cases) compared with our baseline data. We demonstrated that the introduction of a ‘golden patient’ to the trauma theatre list improved the start time and overall operating capacity for the trauma list. Continuing this project, we plan to introduce assessment of all patients with fractured neck of femur in a similar way to the ‘golden patient’ to continue improving trauma theatre efficiency and reduce case cancellations. BMJ Publishing Group 2019-02-18 /pmc/articles/PMC6440604/ /pubmed/30997419 http://dx.doi.org/10.1136/bmjoq-2018-000515 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | BMJ Quality Improvement report Key, Thomas Reid, Gavin Vannet, Nicola Lloyd, John Burckett-St. Laurent, David ‘Golden Patient’: A quality improvement project aiming to improve trauma theatre efficiency in the Royal Gwent Hospital |
title | ‘Golden Patient’: A quality improvement project aiming to improve trauma theatre efficiency in the Royal Gwent Hospital |
title_full | ‘Golden Patient’: A quality improvement project aiming to improve trauma theatre efficiency in the Royal Gwent Hospital |
title_fullStr | ‘Golden Patient’: A quality improvement project aiming to improve trauma theatre efficiency in the Royal Gwent Hospital |
title_full_unstemmed | ‘Golden Patient’: A quality improvement project aiming to improve trauma theatre efficiency in the Royal Gwent Hospital |
title_short | ‘Golden Patient’: A quality improvement project aiming to improve trauma theatre efficiency in the Royal Gwent Hospital |
title_sort | ‘golden patient’: a quality improvement project aiming to improve trauma theatre efficiency in the royal gwent hospital |
topic | BMJ Quality Improvement report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6440604/ https://www.ncbi.nlm.nih.gov/pubmed/30997419 http://dx.doi.org/10.1136/bmjoq-2018-000515 |
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