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Managing urgent surgery as a process: Case study of a trauma center

Published online by Cambridge University Press:  28 March 2006

Paulus Mikael Torkki ,
Antti Ilmari Alho ,
Antti Veikko Peltokorpi ,
Markus Ilmari Torkki  and
Pentti Ensio Kallio
Paulus Mikael Torkki
Affiliation:
Helsinki University of Technology
Antti Ilmari Alho
Affiliation:
Helsinki University of Technology
Antti Veikko Peltokorpi
Affiliation:
Helsinki University of Technology
Markus Ilmari Torkki
Affiliation:
Helsinki University Central Hospital
Pentti Ensio Kallio
Affiliation:
Helsinki University Central Hospital
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Abstract

Objectives: Industrial management principles could be used to improve the quality and efficiency of health care. In this study, we have evaluated the effects of a process management approach to trauma patient care. The major objective was to reduce the waiting times and increase the efficiency of the hospital.

Methods: Urgent surgery care was analyzed as an overall process. The process development followed the Plan-Do-Check-Act (PDCA) cycle and was based on statistical analysis of certain performance metrics. Data were collected from hospital databases and by personnel interviews. To develop the process, the anesthesia induction was performed outside the operating room, better process guidance was developed, and patient flow was reorganized. The transition time for these changes was 1 year (2002 to 2003).

Results: Waiting times decreased by 20.5 percent (p<.05), nonoperative times in the operating room were reduced by 23.1 percent (p<.001), and efficiency was increased by 9.7 percent (p<.001) after reengineering of the care process. Overtime hours decreased by 30.9 percent.

Conclusions: Managing urgent surgical care as a process can improve the productivity and quality of care without a need to increase personnel resources. The focus should be on reducing waiting times and waste times.

Keywords

Process assessmentProcess metricsEfficiencyOperating room managementUrgent surgery
Type
RESEARCH REPORTS
Information
International Journal of Technology Assessment in Health Care , Volume 22 , Issue 2 , April 2006 , pp. 255 - 260
Copyright
© 2006 Cambridge University Press

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References

de Vries G, Bertrand JWM, Vissers JMH. 1999 Design requirements for health care production control systems. Prod Plan Control. 10: 559– 569.Google Scholar
Deming WE. 1986. Out of the crisis. Cambridge, MA: Massachusetts Institute of Technology, Centre for Advanced Engineering Study;
Dexter F, Traub RD, Macario A. 2003 How to release allocated operating room time to increase efficiency–Predicting which surgical service will have the most under-utilized operating room time. Anesth Analg. 96: 507– 512.Google Scholar
Donham RMW, Jones R. 1996 Glossary of times used for scheduling and monitoring of diagnostic and therapeutic procedures. Am J Anesth. 23: 5– 9.Google Scholar
Karvonen S, Rämö J, Leijala M, Holmström J. 2004 Productivity improvement in heart surgery—a case study on care process development. Prod Plan Control. 15: 238– 246.Google Scholar
Laursen M, Gertsen F, Johansen J. 2003 Applying lean thinking in hospitals—exploring implementation difficulties. The hospital of the future. Third international conference on the management of healthcare & medical technology. Warwick, UK: 7–9th September.
Rotondi AJ, Brindis C, Cantees KK, et al. 1997 Benchmarking the perioperative process. I. Patient routing systems: A method for continual improvement of patient flow and resource utilization. J Clin Anesth. 9: 159– 169.Google Scholar
Sokolovic E, Biro P, Wyss P, et al. 2002 Impact of the reduction of anaesthesia turnover time on operating room efficiency. Eur J Anaesthesiol. 19: 560– 563.Google Scholar
Vissers JMH, Bertrand JWM, de Vries G. 2001 A framework for production control in health care organizations. Prod Plan Control. 12: 591– 604.Google Scholar
Waring T, Wainwright D. 2002 Communicating the complexity of computer-integrated operations. An innovative use of process modelling in a North East hospital Trust. Int J Operation Product Manage. 22: 394– 411.Google Scholar
Williams B, Kentor M, Williams J, et al. 2000 Process analysis in outpatient knee surgery: Effects of regional and general anesthesia on anesthesia-controlled time. Anesthesiology. 93: 529– 538.Google Scholar
Young T, Brailsford S, Connell C, et al. 2004 Using industrial processes to improve patient care. BMJ. 328: 162– 164.Google Scholar
Zuckerman JD, Skovron ML, Koval KJ, Aharonoff G, Frankel VH. 1995 Postoperative complications and mortality associated with operative delay in older patients who have a fracture of the hip. J Bone Joint Surg Am. 77: 1551– 1556.Google Scholar