Navigation Links
Operations engineering for more efficient operating rooms
Date:12/2/2008

Work by specialists from the USC Viterbi School of Engineering has led to significant improvements in turnover times for operating rooms at three California safety net hospitals, allowing "many more hours of daytime surgery per year." Because of the success of the program, the work will be expanded to include three more hospitals.

A team from the Viterbi School's Epstein Department of Industrial and Systems Engineering began work in January, 2008 at Childrens Hospital of LA, Riverside County Regional Medical Center and Ventura County Medical Center. "The USC team, along with the nurses and doctors at the hospitals, applied engineering principles such as is done to streamline productivity at Toyota and other efficient organizations," explained researcher David Belson.

According to a September 26, 2008 report on the project made to the study funder, the California HealthCare Foundation, reducing O.R. turnover time was adopted as a goal because "this single metric is easily calculated and can be compared to industry benchmarks."

Turnover time was reduced at all three hospitals, at Childrens Hospital from 34 minutes in November 2007 to 28 in July 2008; from 49 minutes to 39 minutes at Riverside County Regional Medical Center; and from 45 minutes to 34 minutes at Ventura County Medical Center.

"Recommendations are still being implemented and a greater impact is expected," the report states adding that "the 21% average reduction thus far adds many hours of daytime surgery per year for each of the three hospitals studied."

The operational changes made were implemented with cooperation and extensive input from hospital staff. They included, at all three hospitals, efforts to:

  • Balance the capacities of the processes, to reduce queuing, particularly between pre-op and the operating rooms.
  • Improve communications so that people responsible for patient flow were aware of current patient status, when to move patients and overall performance.
  • Develop an accurate published schedule based on past history of surgery and realistic turnover times for all surgeries scheduled in advance.
  • Define scheduling rules so as to avoid bottlenecks, such as equipment shortages, and manage housekeeping support.
  • Implement checklists to avoid delays due to incomplete paperwork on the day of surgery.
  • Implement communications to alert surgeons and anesthesiologists to the time they are needed in the operating room for the next case and when patients are available for interviewing.
  • Create a stable staffing level for housekeeping through the workday.
  • Implement a report card that lets staff know how they are performing and circulate this information widely as an improvement incentive.

Three other hospitals, including San Francisco General in Northern California and Valley Presbyterian and St Francis Hospital in Southern California are now working with the Viterbi School team.

The kind of conditions observed and changes recommended are exemplified in one section of the report, discussing general factors involved in the problem:

"Patient flow in surgery consists of several sequential steps. Just as in a manufacturing flow or other sequential processes, there must be a balance of capacity and a smooth flow of patients. Late arrival at any one step creates delays in subsequent steps. Often a crucial step is the pre-op holding area just before the patient is moved into the operating room. The patient must be in pre-op in sufficient time for interviews by the clinical staff, checking of paperwork and various clinical tasks.

"If the patient arrives without sufficient time before the start of surgery, then the surgery start will be delayed until all the interviews and paperwork is completed. We often found that patients arrived in pre-op less than 15 minutes before surgery was scheduled when one-half of an hour or more was needed."

Some useful adjustments were based on common sense factors rather than sophisticated process engineering. For example: "Given the costs, it would be better to have patients arrive at pre-op early rather than late. Some pre-op and related areas felt that patients were less comfortable in per-op than in the admitting area and therefore slowed movement to pre-op. A better solution would be to improve conditions in pre-op. In one case, we recommended and the hospital acted to move a TV set from admitting to pre-op."

The study is part of the Epstein Department's continuing effort health care engineering. In addition to Belson, the team included Professor Randolph Hall and graduate students Eun Ae (Michelle) Cho, Benigno De Vera and Ashley Crowder, and undergraduate Jessica Midkiff.

"Management engineering improves access to health care as well as reduces costs for the patient," says Belson. "Southwest Airlines has shown how faster turnaround times for planes helps reduce costs and increase passenger satisfaction. We believe health services delivery can learn from examples like these."


'/>"/>

Contact: Eric Mankin
mankin@usc.edu
213-821-1887
University of Southern California
Source:Eurekalert

Related medicine news :

1. Frost & Sullivan Lauds StatCom for Its Hospital Operations System
2. Warriors Unite: Mike Ditka & the Gridiron Greats Form Partnership to Assist Retired NFL Players & U.S. Military Special Operations Personnel
3. Jonathan Jacobson Appointed General Manager, Global Business Strategies & Operations, Menicon Co., Ltd.
4. AmeriCares Launches India Operations
5. Accumetrics, Inc. Appoints William Dippel as Executive Vice President of Operations and R&D
6. AlBaraka Islamic Bank Builds on a Long-Term Partnership With Misys Selecting Misys Equation and Trade Innovation for its Pakistan Operations
7. Neovasc Reports Development Progress, Streamlined Operations and Issuance of Options
8. Blue Cross Blue Shield of Michigan Closes Detroit Operations October 31 Due to Bomb Threat
9. SpectraCell Laboratories Expands Operations in New Facility
10. WILLCARE Chooses Authentidates Inscrybe(TM) Healthcare Service to Streamline Operations and Enhance Business Growth
11. Curemark Appoints Dr. Elisa J. Zinberg as Vice President of Operations
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/24/2017)... ... February 24, 2017 , ... ... TaskMate Go. Core benefits and advantages built into the home office sit stand ... look and feel. Ability to gain the benefits embedded in the TaskMate Go ...
(Date:2/24/2017)... ... February 24, 2017 , ... Houston dentist , ... office, Antoine Dental Center. Currently, patients can get single dental implants for $3,599 ... patients can learn more about these offers by contacting Antoine Dental Center. Both ...
(Date:2/24/2017)... ... February 24, 2017 , ... Only two months after the official release of ... in Cannes (France), XO Private has initiated a second print-run of its lavish luxury ... a metre across when open, weighs in at more than six kilos, retails at ...
(Date:2/24/2017)... ... 24, 2017 , ... WHAT: , The New Jersey Tech ... well as advocacy for the state and region‘s technology businesses, hosted their 2017 ... Council's Innovation Forecast event highlights innovation throughout the region from small to large ...
(Date:2/24/2017)... ... February 24, 2017 , ... An in-depth computational analysis of genetic variants ... points to eight genes that may explain why susceptibility to one of the disorders ... a study published today in the journal npj Schizophrenia. , “There is a ...
Breaking Medicine News(10 mins):
(Date:2/24/2017)... Mass. , Feb. 24, 2017  Today, ... US dental labs have a new path to ... using the Biodenta implant library integrated into exocad ... must implement FDA compliant Good Manufacturing Processes (GMP,s) ... manufacturer with Biodenta, and complete an audit process. Then, ...
(Date:2/24/2017)... Following receiving CE Marking in ... s AMAR is a major milestone for the country where the device ... care market in Israel   ... for inclusion in the National Health Basket , Israel ... E-QURE Corp. (OTCQB: EQUR), a leader in medical devices for the treatment of ...
(Date:2/24/2017)... 2017 Research and Markets has announced the ... - Industry Forecast to 2025" report to their offering. ... The Global Wireless ... 23.8% over the next decade to reach approximately $330.5 billion by ... forecasts for all the given segments on global as well as ...
Breaking Medicine Technology: