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Identifying Causes for Perioperative Bottlenecks
Located in a growing metropolitan area, a local hospital’s space was at a premium. While performing a facility master plan, Catalyst found the hospital needed several new ORs. With an increasing number of cases and the long timeline for adding more ORs, it needed to increase capacity within the current footprint by reducing room turnover time between cases and increasing on-time starts.
Catalyst determined the baseline operations in surgery to identify the root causes driving perioperative operational congestion, bottlenecks, and patient care delivery. Key to Catalyst’s analysis was determining what could be done short-term to improve operational flow and what would require operational changes, modifications to the existing structure, or expansion and redesign.
Using actionable data, Catalyst provided a roadmap to identify reasons for delays in perioperative areas. Analysis of the data didn’t easily identify where to focus to address delays. For example, codes that were entered for root/cause analysis for late cases were entered into the system as free text, resulting in more than 2,000 unique delay codes. To standardize those delay codes, we narrowed them down to a distinct list of 44. When the delay codes were first rolled out, there were no system parameters to force recording of the delay, causing an approximately 60% response rate. That rate was increased to over 95% by the time we finished the project. Standardizing these procedures provided a roadmap to fixing the hospital’s high TOT and increasing first case on-time start.
Catalyst’s successful perioperative strategy was based on two separate unique attributes. First, Catalyst’s on-site team combined engineers and analysts with a registered nurse with extensive operating room expertise, allowing us to provide recommendations that are achievable based on how a hospital actually performs. Second, Catalyst took a substantial amount of time to identify a baseline to accurately determine how the system could be improved. Taking this step gave the hospital actionable data to find the best operational solutions for issues in their perioperative services.