Guiding OR Patient Throughput
THE CASE: Community Medical Center, Scranton, PA
The Challenges
The 299-bed Community Medical Center, an accredited Level 2 regional trauma center performing 11,000 surgical procedures annually in 10 surgical suites, was respected for its century of service. It was also valued for its quality: physicians favored it over its competitors for cardiac and women’s surgeries; but operationally the department was struggling with inefficiency.
To help identify the root cause of these inefficiencies CNO Barbara Bossi called in QHR for assistance:
- Existing surgical environment was worn and outdated
- Complicated scheduling and registration resulted from software issues
- Cramped space slowed productivity in sterile processing; instruments weren’t always ready on time
- Supply shortages frustrated surgeons, as did delays; volume growth slowed: the OR was functioning at 55% capacity
- Surgical / Housekeeping staff could not keep up with OR schedule
Q Solutions
Having studied a wealth of surgical and financial data before their on-site visit, the QHR team began by touring and interviewing their way through the various OR processes – bringing the executive team along in scrubs.
“QHR did a thorough review,” describes Bossi. “They looked at our procedures and workflows in sterile processing and materials management, as well as how anesthesia, scheduling and preadmission testing impacted our effectiveness.”
Based upon evaluation findings, a management action plan (MAP) was presented to the executive staff. This plan prioritized and provided steps needed to implement the change.
Using QHR’s detailed MAP, Bossi launched a multifaceted effort. She organized teams by service line, and tasked the patient safety director with coordination of efforts.
“Thanks to QHR, we realized reporting relationships were ineffective in sterile processing, communication was fragmented in the supply area, and our staffing model was inadequate for room turnover.”
The teams inventoried supplies and instruments, ordering what was needed. Bossi worked with the OR department directors to address many issues: they reorganized space and functions, initiated training and added the role of surgical services aid to prep OR suites between cases.
The Outcome
- In five months, YTD surgical volumes rose 6.7% over prior year, reflecting physician satisfaction with smoother scheduling and case processing
- Already below benchmarks, surgical infection rates have fallen 85%
- QHR’s MAP has been used to make related improvements in other departments such as facilities, pharmacy and IT. The process is gaining momentum daily.
"QHR’s experts were very credible. They came prepared; they got feedback from our people; they worked systematically... and they delivered."
