"We have been standardizing equipment; there is a gold mine in what can be done to improve the system in operating rooms," says Watson.
"We were approaching 13,000 cases a year, and it was getting tight to go through the sterilization process. We had nowhere to expand internally and did not want to take it off campus.
"We had a lot of interruptions," Watson adds. "People had to walk down the hall to get supplies; staff wasn't getting instruments assembled on time."
After initiating the process improvements, the expansion plan was no longer needed and the $3.5 million was allotted elsewhere in the hospital, Watson says. In addition, the hospital increased its caseload from 13,000 to 16,000 cases. The improved efficiency efforts allowed the hospital to open up 500 square feet in the sterilization area.
The hospital spent about $248,000 on consultants and training for staff for the program.
The hospital also reduced waiting times for patients slated for surgery. "We were looking at patients coming into surgery who had preexisting conditions in which they have had to have antibiotics an hour before surgery," Watson says. Previously, at least 60% of those cases resulted in at least an hour delay. Making adjustments in the system, especially making communication improvements, "reduced the delay to zero," Watson says. Specifically, the hospital "standardized antibiotics; we no longer had five different antibiotics used with different doctors. When these kids come in, the charts are marked, and everybody does the standard procedure, and we make sure antibiotics are started appropriately," Watson says.
The hospital also made improvements in radiology. Previously, patients and their families had to wait 28 days for an MRI, and that was frustrating to the hospital, Watson says. After implementing a kaizen plan (Japanese for improvement), the waits do not exceed three days.
The changes were attributed to process revisions, especially in "communication; that's the name of the game," Watson says. "We had people in radiology who worked 100 feet from each other and didn't communicate. Their interactions are key to getting patients scheduled."
In terms of patient satisfaction, the improvements are significant, Watson says. "If your child is waiting for an MRI, and you call the hospital and they say it's four weeks before you get in, there's not a lot of patient satisfaction in that," he says. "Now we can actually schedule patients in the same day." Previously, they had scheduled no more than 80 MRI exams per week, and now more than 130 are scheduled, Watson says.
Success Key No 3: Physicians and IT working together
As part of its innovative approaches, the Sheikh Zayed Institute for Pediatric Surgery at the Children's National Medical Center in Washington, DC, has launched a bioengineering initiative that ensures that an IT engineering team works closely with physicians to provide more efficient procedures and better outcomes for patients, according to Kurt Newman, MD, surgeon-in-chief and senior vice president.