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Surgical capacity is limited by number of O.R.s, regulatory issues and staffing.
Administrator’s desire to increase revenue by increasing utilization of existing space is preferred alternative to building costs and regulatory lead time.
56% reduction in setup time between procedures
16% more procedures / week
Another 16% growth available
Zero acquired infection rate
Operating Room capacity limits caused surgeons to schedule procedures at other area facilities. A meeting with the hospital surgeons confirmed that if capacity could be increased, patients would be scheduled at this facility. This situation was directly and negatively affecting the facility’s bottom line. Increasing capacity by adding additional operating rooms was not an option as it was cost prohibitive and would take considerable time. Surgeons and families are resistant to evening and night surgeries, so schedule based alternatives become limited. The hospital administrators decided to look for a solution that would safely increase capacity of the existing Operating Rooms by one procedure per day.
A Productivity Healthcare consultant working with the hospital improvement team set out to determine if it was possible for the staff to safely perform more procedures during the same time in the existing O.R. suites. The team studied actual operating procedures to look for improvement ideas. They determined that room changeover provided them with the best opportunity to safely increase capacity. Using actual O.R. changeover data, the team focused their efforts on breakdown (clean-up) and set-up activities. Data collected by the team revealed that changeovers between procedures currently varied widely.
The Productivity Healthcare consultant helped the team to create a simulation model of actual procedures. The model indicated if changeovers between procedures could be reduced by 66% then it would be possible to schedule an average of one more procedure per OR per day.
The team held a week long Kaizen event during which they identified key areas that needed to be improved in order to create the desired capacity. Solutions were tested, debugged, and proven during the week. Training documents and scale up plans completed the proof of concept. Using a ‘pitcrew’ model, operations managers segmented a portion of the cleaning staff to be a dedicated OR changeover team. Change time performance data was collected, charted, and analyzed so it could be continually improved and to prevent control slippage.
UTILIZATION AND PATIENT SAFETY IMPROVES
A portion of the cleaning staff was designated to be a dedicated OR changeover team. Change time performance data was collected, charted, analyzed to prevent control slippage. Scale up was done over the next three weeks. Results were critiqued and adjustments made to eliminate resistance to the new process.
Facility utilization increases improved profitability and created more jobs. The focused change team improved sterilization, resulting in zero infections for two years afterwards.
Project Duration: 2 months
The dedicated changeover team’s sterility ability and knowledge grew as the new procedure became part of their daily work and as a result, there were zero infections in the two years following project.
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