Improving Perioperative Performance: The Use of Operations Management and the Electronic Health Record
This is a review of the (2013) article Improving Perioperative Performance: The Use of Operations Management and the Electronic Health Record by Foglia, Adler, and Ruiz.
Background: At Children's Medical Center Dallas, Texas, researchers conducted a study to determine whether the use of operations management and an EHR system could be utilized to improve various aspects of the surgical process.
Methods: This was a retrospective quantitative study that compared the number of first cases on time starts, the number of cancelled surgeries, the total number of surgeries, and the annual revenue between the year prior to the implementation of an EHR and operation management systems and the year following.
Results: The results of this study demonstrated that the year following implementation of the operation management system there was an increase of first case on time starts from 12-30% and a 35% increase in number of surgeries. In addition, the year following the implementation of the EHR system (Epic) the initial first case on time starts decreased to 18%, but subsequently increased to 46%. The possible causes for delays were noted. Overall, the revenue change between pre-implementation, and post-implementation of both systems was found to increase by 53%.
Conclusion: Due to this study, the researchers were able to identify the specific issues or personnel that created delays. This analysis lead researchers to correct the underlying causes of delays through re-education and in-services. The increased efficiency following implementation is likely to result in improved patient satisfaction ratings.
Perioperative environments of hospitals tend to be fast-paced while somewhat resistant to change. This resistance to change, many times, is related to the perception that it will slow down the activities, and subsequently slows down the surgeries and patient flow. This article showed that with implementation of various systems the overall long-term speed of the department was not hindered, and actually improved. It was also shown that through the use of these systems, organizations are better able to identify the causes of issues leading to a redistribution of resources to improve the department. This prevents resources, such as money, time or personnel from being wasted. While this study is not an in-depth evaluation, due to the resulting changes in patient satisfaction it is reasonable to hypothesize that patient/family satisfaction will also improve. This would be very interesting follow-up study.
- Foglia, R. P., Adler, A. C., & Ruiz, G. (2013). Improving Perioperative Performance: The Use of Operations Management and the Electronic Health Record. Journal of Pediatric Surgery, 48(1), 95-98. http://dx.doi.org/10.1016/j.jpedsurg.2012.10.022