Operating Room Quality Improvement Projects
Quality improvement in the operating room (OR) is an important area in cutting health care costs and efficiently processing patients. There is a shortage of surgeons in the United States, and the aging population is on the rise. More efficient and effective OR procedures can assist in saving money and placing a less strenuous workload on today's surgeons.
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Staffing
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An important first project for OR improvement is the creation of a committee--more or less a standing committee--that will look at all aspects of OR policy.
OR nurse Sharon Hohler has put together a team at her hospital in Missouri consisting of one surgeon, two anesthesia specialists and eight OR staff persons, including nurses, to look at areas where quality can be improved. When quality improvement projects are considered, this diverse staff look at problems from every possible angle due to their differing backgrounds and concerns. The first important question that Hohler deals with is timing of operations, or the necessary amount of time needed for both minor and major surgeries. In her case, there was a scheduled time of 20 minutes for major surgeries and 16 minutes for minor surgeries (everything else remaining equal), not including prep or anesthesia administration.
Inventory
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Another significant project is controlling inventory. This process deals both with controlling costs and maintaining a quality surgical establishment. Hohler recommends making sure all equipment comes from the same manufacturer and that all equipment is standardized. Using a single manufacturer cuts costs for transportation and ensures that all equipment parts will work together and be interchangeable if necessary. Furthermore, regular inventory sheets should be filled out so OR staff knows exactly what is available and in what amounts. Requests for equipment during procedures wastes time and money. A standardized accounting of inventory is an important quality project that would be ongoing in an OR.
Scheduling
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Hohler holds that her greatest success is in the development of "scheduling sheets," which work as follows: The doctor schedules a surgery. The hospital then sends two identical sheets by fax--first, to the OR itself, giving a list of supplies needed and listing any special medical circumstances; and second, to the surgery department of the hospital, listing the same thing. This rationalized approach to scheduling has decreased mix-ups in the OR, increased efficiency and elevated the level of preparedness in the OR. These sheets were created with a "fill in the blank" format for ease of use, and their implementation allowed the OR and surgery departments to be fully prepared for the full day's work.
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- Photo Credit operation in a process image by Andrey Kiselev from Fotolia.com
