OPERATING ROOM INTEGRATION AND REDESIGNED PATIENT FLOW CONTRIBUTES TO 61% RETURN ON INVESTMENT…IN 1 YEAR!
ABOUT TBRHSC
Thunder Bay Regional Health Sciences Centre (TBRHSC) is an acute care, trauma, and stroke centre in Northwestern Ontario that serves a population of 270,000 people spread out over an area the size of France.
With 14,460 surgical procedures performed annually in their 14 Operating Rooms, TBRHSC can’t afford to waste any time with duplicated or redundant tasks, unnecessary delays, or a lack of communication. But that’s exactly what was happening every day.
BEFORE CONNEXALL
After being prepped in the Surgical Day Care (SDC) Unit, patients were moved to a holding room where they waited to be picked up by the surgical team when the OR was ready. While in the holding room, a Registered Nurse would recheck the work of the SDC nurses.
The move to the holding room, the double-checking of the prep work, and the patient having to wait for the surgical team were all unnecessary, non-value added steps from the point of view the patient.
In addition to the unnecessary step for patients, staff were frustrated by the lack of information flowing between departments, the OR coordinating nurse was constantly on the phone or physically tracking down individuals and information, and whatever information did exist was fragmented and kept on paper.
In theory, OR attendants and RT’s were available at all times through their pagers, but they were still sometimes difficult to find when needed, had to find the nearest phone to reply to a page, and experienced unbalanced workloads due to the lack of a tracking and distribution mechanisms.
“Communication is consistently defined as one of the biggest challenges facing a clinical program. Finally with Connexall we have a tool to meet our communication needs for now and in the future.“
- Brent N Maranzan, Business Co-ordinator Perioperative Services
THE CONNEXALL SOLUTION
Recognizing the need for improvement, TBRHSC administration completed a comprehensive analysis of patient flow and staff efficiencies. As part of a series of improvements, TBRHSC went live with Connexall in December 2008.
After the project ended, the OR team could:
- Eliminate the holding room from the process entirely, meaning the full-time Registered Nurse could be redeployed to perform more value-added services
- Automate much of the information flow, allowing clerical staff to be redeployed
- Display patient information on wallboards so that staff could all be aware of the patients progress, OR suite availability, and potential and actual delays
- Improve response times to OR code events
- Track response times to events, creating a system of accountability for each individual
INTO THE FUTURE
With a core Connexall system installed, TBRHSC has started implementing a bed status management system that ties their existing clinical information system with Connexall. Building on a family-centered model of care, TBRHSC will link bed availability information with OR and other patient flow information systems. Based on a workflow analysis by the Connexall team, the bed status management system is designed to:
- Allow for the possibility of “virtual” bed rounds
- Link data to alerts via communication devices
- Send bed information alerts to managers
- Send alerts to housekeeping supervisors when beds have not been cleaned for excessive periods
CONNEXALL RESULTS SUMMARY
- Staff able to manage workload better (e.g. plan afternoon breaks, schedule shifts)
- Reduced overtime hours: down 40% compared to year before implementation
- Much quieter front desk
- Better response to codes in the OR
- Better patient care through improved communication
- Pre-surgical delays have decreased
- Track staff notification acknowledgement and response time – useful for scheduling and productivity tracking.
