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PubMedDate not supplied

Effective block scheduling strategies.

The scheduling of surgery provides opportunities to orchestrate a wide variety of resources that have a significant impact on both hospitals, physicians, and patients. This article presents the successful development and implementation of a block scheduling system in a large operating room setting. Strategies include process redesign, automation, and physician empowerment to achieve outcomes of improved efficiency, customer satisfaction and physician self-governance.

Appointments and Schedules↗
PubMedDate not supplied

Design of RCSS: Resource Coordination Systems for Surgical Services using distributed communications.

The plans for Resource Coordination for Surgical Services system (RCSS) incorporate a distributed objectbase with a coordinating server. User-centered information screens are customized for each geographic location in surgical services. User interfaces are designed to mimic paper lists and worksheets used by health care providers. Patient-specific and site-specific data will be entered and maintained by providers at each geographic location, but also rebroadcast and displayed for all providers. Although RCSS is primarily a communications system, it will also support review of surgical utilization and operative scheduling.

Cost Control↗
PubMed2005

Using technology to improve and support communication and workflow processes.

In conjunction with a large expansion project, a team of perioperative staff members reviewed their workflow processes and designed their ideal patient tracking and communication system. Technologies selected and deployed included a passive infrared tracking system, an enhanced nurse call system, wireless telephones, and a web-based electronic grease board. The new system provides staff members with an easy way to obtain critical pieces of patient information, as well as track the progress of patients and locate equipment.

Computer Communication Networks↗
PubMed2002

HIPAA compliance in the OR.

Many current information management practices in the OR will have to change to comply with the Health Insurance Portability and Accountability Act and meet Joint Commission on Accreditation of Healthcare Organizations standards for managing health care information. Demands for accurate, timely, confidential, and secure data make an integrated automated system for information management imperative. Delivering health care in today's OR environment results in enormous amounts of data. Caregivers must transform this data into useable information, while protecting patient privacy, confidentiality, and the security of health care information.

Computer Security↗
PubMed1994

Putting patient-focused care into practice.

Patient-focused care relies on a framework supported by staff member empowerment and cross training, decentralization, patient care teams, and computerization. Decisions are made based on what is best for the patient rather than what is best for the staff members. How patient-focused care is applied is influenced by the basic structure, beliefs, and values of the institution. Empowering staff members and physicians and creating specialty cluster teams were our first steps toward a patient-focused care model. Cross training ancillary personnel to perform all tasks reduced nursing staff members' overtime and allowed for quicker response times during emergencies. Switching to a computerized documentation system enhanced departmental efficiency, removed much of the paperwork burden from nurses, and reduced costs. Patient-focused care is measurable. We have reduced operating expenses, reduced staff turnover, increased productivity, and increased patient and physician satisfaction.

Hospital-Patient Relations↗
PubMed1997

Operating room: 2010.

Using expert systems, virtual reality, and commercial and futuristic technology, visionary operating room (OR) nurses will have the opportunity in the 21st century to dramatically improve the way the OR functions. Eliminating counting, decreasing occurrences of patient injuries, and improving staff and patient education are just some of the possibilities!

Forecasting↗
PubMed2002

Process-optimized operating room: implementation of an integrated OR system into clinical routine.

The surgeon's working environment has changed continuously in recent years regarding the technical complexity of the components in use in the operating room (OR). Parallel to this development, demands for process-optimized procedures have also grown constantly. The impetus for these changes was the beginning of use of minimally invasive techniques in surgery. In contrast, overall development of the OR itself has been slight or nonexistent. What we are typically confronted with currently is an OR outfitted with high-tech medical equipment, whereas only to a limited extent can the design of the OR itself be regarded as ergonomic or holistic. This situation has spread to related specialties as well, and represents a general tendency. Whereas dentists, for example, already enjoy the benefits of a centralized management and operation workplace, this development has not yet reached a satisfactory level for surgeons.

Facility Design and Construction↗
PubMed2005

Creating an optimal operating room schedule.

SCHEDULING IN THE OR suite is a particularly daunting task for many surgical services managers. CREATING AN OPTIMAL OR schedule requires looking at constraining factors as well as historical data. THIS ARTICLE presents one solution to creating an OR schedule that results in increased use of the OR suite and better profitability.

Appointments and Schedules↗
PubMed2003

Using a personal digital assistant to streamline the OR workload.

PERSONAL DIGITAL ASSISTANTS (PDAs), are handheld minicomputers used for tasks such as referencing, documentation, and data storage and retrieval. THESE DEVICES can help perioperative nurses solve problems associated with updating, maintaining, and retrieving surgical preference cards and accessing treatment and medication references. CHOOSING A PDA and accessories, finding basic software, and writing a perioperative nursing program can be painless, even for a novice. NURSING DOCUMENTATION can be accelerated and streamlined with the use of PDAs, which leaves perioperative nurses more time for quality patient care.

Computers, Handheld↗
PubMedDate not supplied

Cost-effective use of operating room supplies based on the REMEDY database of recovered unused materials.

It is estimated that $200 million worth of prepared materials are discarded unused in operating rooms in the United States each year. Although some of these materials have been successfully recovered for overseas donation, they nevertheless constitute an undesirable burden on health care efficiency. This situation has prompted a reevaluation of the procedures that result in the overpreparation of surgical supplies, in the hope of reducing hospital, patient, and third-party payer expenditures. A database, which was initially developed to track the overseas donation of recovered supplies from Yale-New Haven Hospital, is now being applied to measure approaches to waste reduction. This report summarizes the application of this database to an integrated program designed to modify nursing procedures and physician prespecified supply lists.

Budgets↗
PubMed2004

[Possibilities in improving patients's turn-over coordination in the OR of an University Hospital].

An efficient Operating Room (OR) management might increase the cost-effectiveness of an OR. For this purpose, we have evaluated the coordination and the times of the solitary processes that are involved in the patient turnover. The mean time between skin suture of the preceding patient and incision of the following patient (SI-time) was, depending on the type of operation, between 44 and 78 minutes. Mean empty-room time (ERT) was 7 minutes. SI-times depended on various factors, including the times necessary to discharge the preceding patient from the OR and the times necessary for induction of anesthesia or for preparation of the OR. Altogether, our data provide evidence for the fact, that optimisation of the patients turnover can decrease SI-times between 10-15 minutes. Although this period appears too short to reliably allow an additional scheduled operation during regular working hours, an improved coordination may result in reduced overtimes of the OR-staff and thus should increase staff satisfaction.

Appointments and Schedules↗
PubMed2003

Scheduling of elective surgical cases within allocated block-times: can the future be drawn from the experience of the past?

UNLABELLED: We determined a strategy to regulate the elective occupation of operating rooms; it was based on the determination of a median operating room occupation time, per procedure and per operator. METHODS: Median occupation times were determined from a retrospective analysis of 12 consecutive months of operating activity (966 patients). These data were prospectively used in surgical planning, with a daily occupation limit set at 10 hours. After four months collecting data, daily recorded (ROT) and predicted (POT) occupation times were compared. The surgical activity during that test period (group A) was compared to the activity of the same period in the previous year (group B) and the evolution of the waiting lists for surgery were analysed for each of the operators. RESULTS: At the end of the four-month observation period, 317 surgical cases spread over 105 operating days were recorded. The correlation between ROT and POT was strong (r = 0.911, p < 0.001). The relative error in this prediction was 13 +/- 11 min. In comparison with group B, group A was characterized by a significant reduction in occurrence (p = 0.015) and duration (p = 0.007) of time limit overruns and in variability of daily occupation time (p < 0.001). The waiting list was reduced for all operators at the end of the test period. CONCLUSION: Determination of individualized median occupation times, associated with definition of a daily limit, resulted in reduction of time overruns and delays before surgery.

Appointments and Schedules↗
PubMed1990

Comprehensive surveillance of surgical wound infections in outpatient and inpatient surgery.

A surgeon-specific computer-generated monthly questionnaire was used to improve surveillance of surgical wound infections in outpatients as well as inpatients following discharge. From July 1988 through June 1989, 20,536 surgical procedures were performed at our medical center, of which 53% were for outpatients. The total wound infection rate was 0.63%: 0.13% in outpatients and 1.2% in inpatients (p less than .005). Of the infected wounds, 20% were reported by the survey alone and would have gone undetected by conventional surveillance methods (71.4% of outpatient and 13.8% of inpatient wound infections). As a whole, clean and clean-contaminated wounds in outpatients were much less likely to become infected than those in inpatients. Wound cultures were not obtained in 85% of infections reported by the survey alone, and were less likely to be obtained in outpatients. The average time spent by the infection control department on the survey was approximately two hours per week.

Ambulatory Surgical Procedures↗