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Pre-Op Cycle Time for Subsequent Cases
Performance Improvement 2022
Goal: To achieve a subsequent case pre-op cycle time of 45 minutes or less across the three main PeriAnesthesia areas on Stanford Health Care's main campus.
Organizations continuously strive to seek opportunities to improve and provide the best patient experience possible, through the most efficient path. The success of the Go Sticker on Time project in 2019, motivated the team to identify more opportunities for improvement which led the team to focus on “Pre-op Cycle Time for Subsequent Cases” for the fiscal year 2022.
The pre-op cycle time is measured in minutes from the start of nursing pre-op to completion, using case tracking event documentation on Epic. Trending data reports were reviewed by the team on a weekly basis. This focus was identified by the team as an essential opportunity to improve efficiency in prepping patients when it comes to productive minutes, enhancing accountability from nurse driven countermeasures, and empowerment of the frontline clinical nurses. In a span of months, the PeriAnesthesia team has achieved and maintained a subsequent case pre-op cycle time of 45 minutes or less 90% of the time across the three PeriAnesthesia areas on the main campus.
Successful Outcomes:
PeriAnesthesia team has achieved and maintained a subsequent case pre-op cycle time of 45 minutes or less 90% of the time across the three PeriAnesthesia areas on the main campus.
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Achievements – big and small – were celebrated on a regular basis, from the unit level to the entire IP level.
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Ideas were generated as more conversations occurred at the unit level beginning with identifying root causes to the development of countermeasures.
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collaboration, thoughtful review and examination of data, problem solving supported by Lean methodology, and the PDCA (Plan Do Check Act) concept.
The PeriAnesthesia team within the Interventional Platform (IP) started its Performance Improvement (PI) journey in 2019. The team started with “First Cases Go Sticker on Time” project and has achieved and sustained success. Go Sticker is a pre-op case tracking event documented on Epic which denotes that the patient has been prepped and is all ready to proceed to the Operating Room (OR) for procedure or surgery. It involves all the nursing aspects and safety checks by a pre-op nurse, as well as documentation required of the surgical or procedural team. First cases were initially identified as having the greatest opportunity for improvement as first-case delays had a snowball effect on consequent cases.
Within one year, the PeriAnesthesia team achieved and sustained the goal of Go Sticker by 7:10 am, 70% of the time for first cases across 500P Pre/Post, 300P Pre/Post, Lane Pre/Post, and Cath Angio Pre-Procedure and Recovery.
Submitted by: Eddah General MSN, RN, Caritas Nurse®, Patient Care Manager – 300P Pre/Post and CAPR
Jonathan Villagracia, MSN, RN, CAPA, NEA-BC, Patient Care Manager- Lane P/P and IR P/P