220 - Aligning Incentives for Operating Room Efficiency and Satisfaction
Description: Study Question: How will creating a process to jointly incentivize the multidisciplinary team members of the Zayed/Bloomberg Operating Rooms (ZBOR) contribute to OR efficiency, as defined by an increase in on-time starts and less than 45 minutes turnover times?
Background: Team members of the Johns Hopkins Hospital ZBOR 3 identified challenges within the daily operations due to increased surgical volumes and maximized use of allotted Operating Room (OR) space. In an effort to improve the daily operations, shorten turnover times (TOT), increase efficiency, and improve physician and staff satisfaction, a review of the literature was conducted, insight was gathered from large academic institutions to compare processes and past lessons, successes and opportunities were utilized to guide the study. The focus was to demonstrate a relationship between an aligned incentive program and improved efficiency within the OR setting by creating a shared goal within the nursing, anesthesia and surgical teams. Design
Description: The ZBOR team members utilized the GROW model as the framework for creating the pilot:•The Goal was to pilot a process of incentivizing multidisciplinary team members to work collaboratively and efficiently to ensure on-time starts and turnover times less than 45 minutes. •The Reality demonstrated that the ZBOR 3 multidisciplinary team meets the metric of in room on-time starts of 0730a, Monday, Tuesday, Wednesday and Friday, and 0845a on Thursdays less than 60% of the time for various reasons and averages turnover times defined as “wheels out to wheels in” greater than 60 minutes. The number of cases extending past the 5p block schedule continues to grow, while the metrics above remain the same. Members of the teams are tired, dissatisfied, and lack a common incentive to motivate progress. •The Options were to continue to meet and discuss, monitor data, suggest solutions, provide education, send emails requesting reasons for non-compliance, etc. or try a unique and visionary process. •The ZBOR multidisciplinary team decided they Will try a unique and visionary process Methodology: The process included communication to all stakeholders, the identification of a pilot room, clear objectives for success, and evaluation of the day. The steps outlining the process were as follows:•Provide communication to all parties: Surgeons, Anesthesia, and Nursing outlining the pilot and the potential benefits•Provide a mechanism for real time communication and evaluation•Ensure the pilot room has cases scheduled for the full block, 0730-1700•Selection of the pilot room will occur the day prior to surgery by the Nursing Coordinator and Charge Nurses and the team assigned will be notified. •It is the responsibility of all team members to monitor the interactions, the resources utilized and the communication experienced in order to identify best practices. •Evaluations from the team members will be submitted to the Nurse Manager daily