Track: Clinical Improvement/Innovation
Clinical Improvement/Innovation Poster Session (Posters #344-#353)
AORN Poster Presentation Abstract
Increasing First Case On-Time Starts in an Ambulatory Surgery Center
Maine Medical Center Scarborough Surgery Center
QI/Clinical Practice Innovations Poster
The purpose of this Operational Excellence performance improvement project was to increase the percent of first cases of the day that start on time to 70% or greater in a ten room ambulatory surgery center.” On-time” was defined as starting on or before the scheduled surgery patient in the room time (no “grace period”). Improving on-time first case starts within Maine Medical Center (MMC) Scarborough Surgery Center (SSC) is important as it directly affects the patient experience as well as the respect between members of the operating room team. Patients expect to have a procedure started within a reasonable time after their arrival. When delayed, this causes patient and family anxiety and delays subsequent patients in a cascading impact. Through this initiative, MMC SSC will be positively impacted by improved patient satisfaction, as well as an increase in care team well-being with improved respect, efficiency, and accountability from all team members.
A multidisciplinary First Case On-Time Starts Workgroup was formed and case delay data was collected. A root cause analysis of the causes for late first case starts revealed surgeon late arrival (42%), patient late arrival (16%), and medication issues (8%) accounted for 66% of the late starts. Actions were taken to address these issues, including 1:1 conversations with late surgeons followed by posting names of late surgeons, adjusting patient arrival times for specific patient populations, calling all first case patients the day before to remind of arrival time, and staffing an onsite pharmacist.
Outcomes improved and on time first case starts, averaging 50.2% in October 2018, improved to 76% and 69% in May and June, 2019, respectively.
Director/VP/Asst Director Nursing
Scarborough Surgical Ctr