323 - Decreasing Ophthalmology Turnaround Times in an Ambulatory Surgery Center Utilizing the Lean Process
Description: Jennifer and Annemarie are nurses in New York Presbyterian’s David H. Koch Center (DHK) ambulatory surgery unit, which opened its doors on April 30, 2018. Jennifer, an OR nurse for 3 years, and Annemarie, an OR nurse for 6 years, work in a variety of specialties at the facility. Inefficient workflows lead to cases extending past block time and longer patient stays, an undesirable occurrence in the ambulatory surgery setting. When opening the new surgery center, the goal for turnaround time (TAT) was set to 15 minutes, compared to the 20 minute goal in the original OR facility (F10). F10 workflow is heavily reliant on Perioperative Patient Assistants (PPAs) and their ability to get into the room and clean quickly. Due to the expected case volume increase at DHK, as well as new staffing designs and floor layouts, a new workflow had to be created. Various trials have concluded that utilizing the Lean Process, which defines value-added and non-value-added items after careful assessment of the workflow process, results in decreased TATs in the OR. The ophthalmology service was used to pilot this Lean Process initiative and change in workflow. Non-value added steps were eliminated including mopping of non-soiled floors, and value-added processes were either added, altered, or streamlined. The new TAT workflow at DHK focuses on a team approach and streamlined process, where each team member has a designated but fluid role. By eliminating non-value-added items, and streamlining value-added events, TATs have been significantly reduced, and patient and staff satisfaction have been increased. TATs at DHK average 7.5 minutes less than F10.