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A Quality Improvement Project to Improve First Case On-time Starts in the Pediatric Operating Room

BACKGROUND: Delays in the operating room (OR) can lead to increased hospital costs as well as patient and provider dissatisfaction. Starting the first case on time in the OR can potentially prevent subsequent delays. We designed a quality improvement project to improve the first case on-time starts...

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Autores principales: Pashankar, Dinesh S., Zhao, Anna M., Bathrick, Rebecca, Taylor, Cindy, Boules, Heidi, Cowles, Robert A., Grossman, Matthew
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7339335/
https://www.ncbi.nlm.nih.gov/pubmed/32766485
http://dx.doi.org/10.1097/pq9.0000000000000305
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author Pashankar, Dinesh S.
Zhao, Anna M.
Bathrick, Rebecca
Taylor, Cindy
Boules, Heidi
Cowles, Robert A.
Grossman, Matthew
author_facet Pashankar, Dinesh S.
Zhao, Anna M.
Bathrick, Rebecca
Taylor, Cindy
Boules, Heidi
Cowles, Robert A.
Grossman, Matthew
author_sort Pashankar, Dinesh S.
collection PubMed
description BACKGROUND: Delays in the operating room (OR) can lead to increased hospital costs as well as patient and provider dissatisfaction. Starting the first case on time in the OR can potentially prevent subsequent delays. We designed a quality improvement project to improve the first case on-time starts in the pediatric OR at a tertiary care children’s hospital. METHODS: Following the collection of baseline data, we formed an interdisciplinary team. We analyzed the causes of delay and used the Six Sigma methodology of Define, Measure, Analyze, Improve, and Control. We identified key drivers and implemented several low-cost interventions using Plan-Do-Study-Act cycles. Major interventions included preoperative care coordination, strategic staggering of OR cases, and introduction of “Wow Bucks” incentives. We monitored start times and the delay in minutes for all first cases weekly. The OR minutes saved per week were calculated and used to estimate cost savings. RESULTS: We studied a total of 1981 first-start cases from May 2018 to October 2019. The first case on-time starts improved from 62% to 77% over the study period. There was a significant improvement in total minutes delayed for all the first cases from 197.9 minutes per week down to 133 minutes per week (P < 0.05). Estimated cost savings were $4,023 per week due to improved OR utilization. CONCLUSIONS: A multidisciplinary collaborative team approach using quality improvement tools can improve on-time starts in the pediatric OR.
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spelling pubmed-73393352020-08-05 A Quality Improvement Project to Improve First Case On-time Starts in the Pediatric Operating Room Pashankar, Dinesh S. Zhao, Anna M. Bathrick, Rebecca Taylor, Cindy Boules, Heidi Cowles, Robert A. Grossman, Matthew Pediatr Qual Saf Individual QI Projects from Single Institutions BACKGROUND: Delays in the operating room (OR) can lead to increased hospital costs as well as patient and provider dissatisfaction. Starting the first case on time in the OR can potentially prevent subsequent delays. We designed a quality improvement project to improve the first case on-time starts in the pediatric OR at a tertiary care children’s hospital. METHODS: Following the collection of baseline data, we formed an interdisciplinary team. We analyzed the causes of delay and used the Six Sigma methodology of Define, Measure, Analyze, Improve, and Control. We identified key drivers and implemented several low-cost interventions using Plan-Do-Study-Act cycles. Major interventions included preoperative care coordination, strategic staggering of OR cases, and introduction of “Wow Bucks” incentives. We monitored start times and the delay in minutes for all first cases weekly. The OR minutes saved per week were calculated and used to estimate cost savings. RESULTS: We studied a total of 1981 first-start cases from May 2018 to October 2019. The first case on-time starts improved from 62% to 77% over the study period. There was a significant improvement in total minutes delayed for all the first cases from 197.9 minutes per week down to 133 minutes per week (P < 0.05). Estimated cost savings were $4,023 per week due to improved OR utilization. CONCLUSIONS: A multidisciplinary collaborative team approach using quality improvement tools can improve on-time starts in the pediatric OR. Lippincott Williams & Wilkins 2020-06-24 /pmc/articles/PMC7339335/ /pubmed/32766485 http://dx.doi.org/10.1097/pq9.0000000000000305 Text en Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Individual QI Projects from Single Institutions
Pashankar, Dinesh S.
Zhao, Anna M.
Bathrick, Rebecca
Taylor, Cindy
Boules, Heidi
Cowles, Robert A.
Grossman, Matthew
A Quality Improvement Project to Improve First Case On-time Starts in the Pediatric Operating Room
title A Quality Improvement Project to Improve First Case On-time Starts in the Pediatric Operating Room
title_full A Quality Improvement Project to Improve First Case On-time Starts in the Pediatric Operating Room
title_fullStr A Quality Improvement Project to Improve First Case On-time Starts in the Pediatric Operating Room
title_full_unstemmed A Quality Improvement Project to Improve First Case On-time Starts in the Pediatric Operating Room
title_short A Quality Improvement Project to Improve First Case On-time Starts in the Pediatric Operating Room
title_sort quality improvement project to improve first case on-time starts in the pediatric operating room
topic Individual QI Projects from Single Institutions
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7339335/
https://www.ncbi.nlm.nih.gov/pubmed/32766485
http://dx.doi.org/10.1097/pq9.0000000000000305
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