Improving Perioperative Performance: The Use of Operations Management and the Electronic Health Record

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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.[1]


Article Summary

Background: At a large children’s hospital system in Dallas, Texas, researchers conducted a study to determine whether the use of 2 types of electronic systems 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 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.

Article Analysis

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 slow 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 also showed that by using these systems, organizations are better able to identify causes of issues, which then can lead to a redistribution of resources to improve the department. This would allow resources, such as money, time or personnel to be wasted. While this study does not describe or evaluate in detail, the resulting changes in patient satisfaction, it is reasonable to hypothesize that patient/family satisfaction would improve and it would be very interesting to study this factor in detail.


References

  1. 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