Group 1_BCMH Surgical Unit

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University of Texas, El Paso *

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4304

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Health Science

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Apr 3, 2024

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pptx

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Blue County Memorial Hospital Surgical Unit Bianca Huntsman (PM), Jessica Nelson, Ericlyne Kohn-Armah, Ahmad Al-Turck
Mission Statement • Our aim is to reduce time that the patients must wait for service. • Overall, we are aiming to provide high quality service.
Goals • Be considerate to patient emotional need before and after surgery • Reduce patient wait times • Proper use of space and resources that we have • Reduce post-surgical complications • Provide care that is centered around the patients
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Goals (minimal wait time) ❖ Provide care that is centered around the patient ➢ Put in place surgical case managers (prior to check in) ➢ Provide electronic check in via email prior to surgery ➢ Give patients and staff access to electronics forms for surveys ➢ Work on ways to improve patient satisfaction scores by 15% ❖ Increase start time to be accurate 90 to 95% within 6 months ➢ Look into staff workload (improve team work) ➢ Improve the process of data entry during the intake process ➢ Make sure that all staff know their roles and responsibility ➢ We will create a start policy of being on time with cases that will be enforced (Parker, Hattle, Prejeant & Stock, 2006)
Average First Case Delay by service line (Parker, Hattle, Prejeant & Stock, 2006) Prior to goals
Average First Case Delay by service line (Parker, Hattle, Prejeant & Stock, 2006) When start time is at 90% low
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Goals (Caring about patient emotional needs) ❖ Be considerate to patient emotional need before and after surgery ➢ Make patient scheduling of surgery available and easy to access ➢ update patient of the surgery times two days prior to the schedule appointment ➢ Have at least 2 extended care surgical appointment to ensure confidentiality of the patients ➢ Decrease time to reply to patient demand/questions by about 15% with 7 months. ❖ Decrease patient Response time to surveys ➢ Improve patient satisfaction by 15% ➢ Put in place surgical case managers with a ratio of 1 case manager to 3 surgical cases per working day. ➢ Communicate between care team to ensure patient satisfaction
Goal (Improve Patient Centered care) ❖ Better patient satisfaction score by 15% within the next 7 months Continuous assessment of patient of quality care Make feedback accessible to all staff part of that particular patient care Make easy to understand Surveys ❖ Put in place surgical case managers with a ratio of 1 Case Manager to 3 surgical cases per working day of our current quarter ➢ Know patient need and assign proper Case Manager prior to arrival ➢ Know and understand the patient needs in details ➢ Case Manager will assist patient with the case and helping them understand their need in order to make their specific need and demand go accordingly.
(Parker, Hattle, & Stock, 2006)
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Quality and Process Improvement • Risks to Surgical Unit’s Operations • Metrics and Review of Data • Continuous Improvement
Risk & Mitigation •Staffing Shortage •Employ adequate PRN staff •Locum Tenens for general surgeons •Pharmaceutical Shortages •Maintain communication with Pharmacy regarding shortage notices in order to best plan accordingly • Cancellations •Monitor caseloads •Ensure pre-surgical labs complete
Review of Data •Metrics reviewed monthly at QAPIC meetings •OR Nurse Manager to regularly update staff on performance as guided by metrics •OR Nurse Manager to review pertinent data with Physicians/Surgeons group
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Metrics
Continuous Improvement ● Measurement tools ○ Surveys ○ Discharge plan ○ Follow up
Financial Consideration ● Option 1: Outsourcing 100% Nurses ● Option 2: In-house/Outsource Nurses ● Option 3:Nurse/Surgical Med Tech/PCT
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Scheduling
Operational Hours, Supply & Demand • Operational Hours : 8am-5pm • Staff: Dependent on Demand of Surgeries • Demand for surgical intervention has increased by 38%, • Decrease wait times, we would need to add about four hours
Demand for Surgery Per Quarter
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Floor Plan ( Facility Guidelines Institute, 2018)
Floor Plan (cont) ( Facility Guidelines Institute, 2018)
Floor Plan (cont) ( Facility Guidelines Institute, 2018)
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Floor Plan (cont) (Cahman, 2017)
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Current Schedule Monday-Friday 8am- 5:00pm Our Schedule Monday-Friday 6am- 6pm Reduce patient wait time Be considerate of patient need
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OR Suite schedule
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Reference: • Parker, M., Hattle, R., Prejeant, D., & Stock, G.. (2006). Starting the first surgical case on time to cut delays. Retrieved on November 30th 2018 from https://www.isixsigma.com/new-to-six-sigma/dmaic/starting-first-surgical-case-time-cut-delays • Cahman, C. (2017). Design guidelines for short-stay patient units. Retrieved from https://www.hfmmagazine.com/articles/2841-design-guidelines-for-short-stay-patient-units • Facility Guidelines Institute. (2018). 2018 Edition - FGI - Facility Guidelines Institute. Retrieved from https://www.fgiguidelines.org/guidelines/2018-fgi-guidelines/
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