Info
Perioperative Best Practices
Perioperative best practices improve employee, patient and family satisfaction. In addition, perioperative best practices:
Increase surgical volume
Increase contribution margin
Decrease staff overtime
BEST PRACTICES
Create effective and efficient scheduling guidelines to optimize patient flow to improve access and volume growth. To do this:
Develop and evaluate guidelines for scheduling of procedures. Guidelines should include processes to follow for all scheduling scenarios, from routine case scheduling to same day emergent add-ons and factor in clean-up/set-up duration.
Preregister all procedural cases with concise demographic and financial requirements to avoid unnecessary delays and cancellations on the day of procedure.
Use visual cues/icons to communicate real time changes in the procedure schedule, such as add-ons, time change, location change or procedure change, to ensure staff productivity.
Schedule procedures for inpatients and outpatients who will not require a new inpatient bed assignment as first cases or early in the day to allow adequate time for planned inpatient discharges and bed turn times.
Perform isolation cases as the last procedure of the day, or in designated locations, to eliminate the need for multiple terminal cleans per day which can cause delays and decrease utilization.
Develop a formal definition of start-time and educate all team members to ensure better alignment of time performance.
Utilize reporting to verify and confirm the schedule to review accuracy of actual vs. scheduled duration; track and trend data and report deviations to the provider.
Maximize procedure room utilization through increased visibility, real time alerts and triggers to proactively position the hospital for growth. To do this:
Utilize the ScheduleVue™ Screen to identify real time gaps and overlaps and proactively adjust the schedule to maximize room utilization.
Ensure all changes, including add-ons and cancellations are updated, monitored and communicated in real-time, to maximize utilization of staff and rooms.
Utilize prominently displayed electronic boards in high traffic areas with surgical schedule, including cases scheduled, patients, providers, staff and resources that can be updated real time.
Communicate the intraoperative and room turnover milestones real time to perioperative staff to allow for timely preparation of patients and resources.
Display accurate/updated staff assignments to promote visibility of staff resources. Increased visibility of the schedule will ensure staff are aware of assignments to facilitate more efficient room utilization such as shifting cases or reassigning staff.
Discuss individual staff role expectations and capture accurate and efficient room cleaning times related to room turnover to ensure accountability of room turnaround staff.
Streamline perioperative flow and on-time starts through efficient patient preparation. To do this:
Ensure incomplete medical records are identified timely and expedited including history & physical exam, consent, pending labs and X-rays to facilitate on-time starts.
Ensure all procedure cases are given clear preoperative instructions, including arrival time and NPO to avoid unnecessary delays and cancellations for the day of procedure.
Leverage system real time to communicate patient readiness by ensuring all caregivers signal their readiness by triggering their corresponding icons timely.
All delays that will impact scheduled procedure will be viewed in real time by receiving department; allowing for in the moment rescheduling of staff, resources or room utilization.
Capture real time patient arrival and movement so nursing, physicians, techs and volunteers are aware of patient status immediately via real time electronic screen updates and/or device alerts.
Utilize automated escalation alerts to notify staff of extended wait periods so staff can intervene or further communicate with the patient.
Ensure designated preoperative charge member to monitor the overall flow of the preoperative suite to expedite the impediments to patient readiness.
Leverage real time communication and status updates to improve patient and family satisfaction throughout the perioperative journey. To do this:
Utilize the FamilyVue® screen in waiting areas to allow for real time updates of patient movement through the perioperative suite to decrease phone calls and improve communication with family/visitors.
Utilize Family Icon to signal patient is ready to receive visitors without a phone call.
Activate service recovery through active monitoring of length of stay in all areas.
Utilize Precision Patient Placement to decrease recovery area hold time and to ensure the right patient is going to the right bed the first time. To do this:
Utilize patient/bed attributes and isolations to increase accuracy of placements.
Utilize Ready to Move to indicate the patient is recovered and prepared for bed assignment to ensure a ready bed for a ready patient.
Request transport as soon as assigned bed is clean and patient is ready to move to avoid delays.
Enhance provider and anesthesia on-time arrivals through effective and real time communication. To do this:
Contact provider 15 minutes prior to scheduled start time if he/she has not arrived.
Notify providers and anesthesia personnel of any scheduled time changes.
eport all case delays to surgical services committee and anesthesia committee.
POTENTIAL OBSTACLES & CONSIDERATIONS
Potential obstacle: Inaccurate scheduling of procedures, e.g., duration and line-up
Considerations:
Follow up with surgeon regarding requested case duration vs. historical case uration to avoid case delays and decrease overtime.
Potential obstacle: OR process delays, such as staff delay or instrument delay
Considerations:
Ensure appropriate number of high-volume instruments and trays are available to prevent delays.
Schedule special equipment on schedule the prior day afternoon to ensure equipment availability.
Install electronic boards with the Clinical Workflow Suite application in the Sterile Processing Department for visualization of the Schedule Vue to prevent instrument delays.
Potential obstacle: Lack of staff resources needed for room turnover
Consideration:
Assign room turn teams to specific ORs during prime OR hours.
CONFIDENTIALITY AGREEMENT
I acknowledge that by accessing this information, I understand and agree to the following: This webpage, and any presentation or materials made available through this webpage, contains proprietary and confidential information of TeleTracking Technologies, Inc. This information is provided only for use by a client or prospective client of TeleTracking Technologies, Inc. for the sole purpose of evaluating TeleTracking solutions for use in client or prospective client facilities. Any downloading, recording, distribution, disclosure, printing, copying, storage, or modification of these materials without the express prior written permission of TeleTracking is strictly prohibited. Disclosure of these materials to any person other than representatives of a client or prospective client pursuant to this acknowledgment is strictly prohibited.