Quality improvement intervention cuts lost OR time

(HealthDay)—Significant reductions can be made in operating room (OR) time lost due to cancellation on the day of surgery (DoSC), according to a study published online April 13 in Pediatrics.

Jayant "Nick" Pratap, M.B., B.Chir., from the Cincinnati Children's Hospital Medical Center, and colleagues conducted serial tests of change, addressing the various key drivers of a quality improvement process designed to reduce lost OR time due to DoSC. The key drivers included effective two-way communication with families, fasting rule compliance, and decision-making due to patient illness. Interventions included simplified, colorful, personalized preoperative instruction sheets and text-message reminders to caregivers' cellphones. In case of patient illness concerns, there was a defined institutional decision-making pathway to permit rescheduling before the day of surgery. The interventions were implemented across all patients and sites after initial smaller-scale testing.

The researchers found that in testing with a subset of surgical services at the hospital's base campus, there was a decrease in mean OR time lost due to DoSC, from a baseline of 5.7 to 3.6 hours/day. When the intervention was implemented across all services at both surgical sites, the mean OR time lost due to DoSC decreased from 6.6 to 5.5 hours/day.

"By applying quality improvement methods, significant reductions were made in time lost due to DoSC," the authors write. "The impact can be significant by improving institutional resource utilization."

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