On the day of surgery: how long does preventable disruption prolong the patient journey?

• Published in: International journal of health care quality assurance 2012-01, Vol.25 (4), p.322-342
• Main Authors: Al-Hakim, Latif, Yan Gong, Xiao
• Format: Article
• Language: English
• Subjects: Avoidable; Communication; Continuity of Patient Care; Coordination; Disruption; Efficiency, Organizational; Elective surgery; Health administration; Health services; Hospitals; Humans; Job design; Length of Stay - statistics & numerical data; Literature reviews; Medical errors; Operating theatres; Patient care; Patient Care Management - methods; Patient positioning; Perioperative Care - methods; Process Assessment (Health Care); Quality Improvement - organization & administration; Quality of care; Studies; Surgeons; Surgery; Surgical Procedures, Operative - statistics & numerical data; Time Factors; Turnover; Waiting lists; Workflow
• ISSN: 0952-6862; 1758-6542
• DOI: 10.1108/09526861211221509

Purpose - Disruption considerably prolongs session times for surgery, affects the quality of patient care, and prolongs waiting lists. In addition, there is a strong relationship between disruption and surgical error. This research aims to provide a platform for healthcare services to identify the sources of preventable disruption affecting operative time within the perioperative process and to effectively reduce it.Design methodology approach - Events inside and outside operating rooms that disturb the operative time were recorded for 31 elective surgeries over the period of five months. Disruption events were classified according to the hospital's requirements and the findings were reviewed by the surgical teams. Lean thinking approaches were used to achieve the purpose of this study.Findings - Preventable disruption caused an increase in surgical time of approximately 25 per cent. Preventable disruption consisted of poor information flow, failure to follow concepts of methods study, lack of communication and lack of coordination. Coordination failures were the main reason for disruption followed by the lack of following the principles of motion economy.Originality value - Surgical disruption has substantial financial implications for hospitals. This research indicates that it is possible to reduce operative time considerably by eliminating preventable disruption. Such additional time could be utilised to deal with the pressure of emergency cases, reduce the waiting lists for elective surgery, increase operating room utilisation, and reduce medical errors.