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How Patient-centered Surgery Boosts Hospitals' Bottom Line

Health Governance Report, September 9, 2010

Improve OR efficiency

Although a lot of the changes to make surgery more patient-centered happen before and after the actual surgery, the quality and speed of the operation is one of the most important elements of patient satisfaction. 

OR teams have been working for years to improve the efficiency and safety of hospital ORs, and many of the best improvements have come from other industries, says Opelka. The surgical checklist, similar to what pilots use before takeoff, is perhaps the most well-known example. But many surgical teams have also adopted simulation team training from the airline industry to prepare for emergency situations.

After-action reports adopted from other industries and other methods of analyzing performance are also helping OR teams learn from every operation to improve the overall process and, most importantly, the performance.

To discover ways to improve OR work flow, DiGioia and his team mounted several video cameras in the OR to record a series of hip and knee operations. This enabled surgeons and nurses to perform their normal routines while timing each stage of the operation and identifying areas for improvement.

For example, simple steps such as introducing the anesthesiologist in the room could take anywhere from two to nine minutes. The care team learned that they could standardize some of those steps and cut down overall turnaround time.

“OR efficiency is not only good for the hospital and the OR team, but the patient as well,” says DiGioia. “But remember, it’s good to look at OR efficiency, but the patient’s care experience involves a lot more than just the surgery.”

Surgical CAHPS 

The new surgical Consumer Assessment of Healthcare Providers and Systems (CAHPS) has questions not found on the original CAHPS survey, including the following:

  • During your office visits before your surgery, did this surgeon tell you there was more than one way to treat your condition?
  • After you arrived at the hospital or surgical facility, did this surgeon visit you before your surgery?
  • Before you left the hospital or surgical facility, did this surgeon discuss the outcome of your surgery with you?
  • After you arrived at the hospital or surgical facility, did this anesthesiologist visit you before your surgery?
  • During your office visits before your surgery, did this surgeon or a health provider use pictures, drawings, models, or videos to help explain things to you?
  • Did this surgeon make sure you were physically comfortable or had enough pain relief after you left the facility where you had your surgery?
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