Assessment
During the initial assessment, Philips consultants analyzed multiple data sources to determine current state performance, understand department flow, and define the current baseline for analysis to support the creation of actionable recommendations. Data sources used included staff interviews, scheduled case durations, block schedule, on-site observations, and industry best practices.
Assessment recommendations
Based on the assessment, a three-phase approach was proposed to provide comprehensive ongoing leadership and change management coaching:
- Phase One: Focus on data management
- Phase Two: Focus on operational performance
- Phase Three: Focus on program management
The goal was to continuously improve surgical services performance, effectively deploy change, achieve annual and longer-term performance targets, and innovate for expected future growth.
Phase One performance improvement project
Nash UNC Health Care leadership team committed to a short 12-week Phase One surgical services performance improvement project focused on data management.
Phase One deliverables included:
- Redesign Epic dashboard with defined KPIs and drive improvement to reduce room turnover time (TOT), improve first case on-time starts (FCOTS), and reduce day of surgery (DOS) cancellation and/or delays
- Resolve data integrity issues within data mapping
- Optimize doctor preference cards to ensure proper resource allocation and case and procedure durations
- Map data fields for enhanced inventory management and charge capture
- Propose future state staffing models to align with key operational improvements
Approach
To assure staff involvement and ‘buy-in’, performance improvement activities were carried out by four separate workgroups: FCOTS, room TOT, cancellations and delays, and doctor preference card redesign. Each group was tasked to build current states, figure out the problems, and come up with counter-measures to develop a solid future state. Facilitated by a Philips subject matter expert, each workgroup then created new policy statements and defined how changes would potentially impact staff.
Knowing how to drive toward best practices was a key takeaway for all the staff. An understanding of how to strive for, achieve and sustain each KPI, put them on track for continued success. By giving them the tools they need to succeed, Nash UNC Health Care can now measure performance improvement and sustain ongoing change management of same.
Additional customization within the electronic system, validation of data, and streamlined future state processes sustains the drive toward improvements with KPIs. Adherence to KPIs keep the surgeons happy and the day flowing smoothly.
Results
Design and implementation efforts were focused on efficient patient flow through the surgical continuum. Greater transparencies were created regarding data definitions/calculations, surgical scheduling, and doctor preference card maintenance within the electronic system.
