The main priority of the political system, not only in Italy but also internationally, is to reduce public debt and to streamline National Health Service (NHS) costs. Consequently, health managers need to acquire operating methods within their managerial structures so that all available resources are better planned in terms of effectiveness and efficiency, without compromising patient safety. In recent years, scientific and legislative landscapes have focused attention on the activity of the hospital surgical unit, considering it to be high risk, both in economicfinancial and patient safety terms. This has motivated the requirement to closely monitor all tasks performed by the various health professionals involved in the complete path of the surgical patient. In the operating room, monitoring of total process time and collecting data are difficult to obtain because of the complexity of the system with many ORs and collateral areas.
What this hospital produced is a collecting operating rooms data system, represented by logistic and human resources. They use a univocal identification of each operative room using a barcode image that is located on the main door of every OR and a univocal identification of each anaesthetic nurse using a Personal Digital Assistant. The nurse is logged in and the PDA software produces a connection between the nurse and the patient; univocal identification of the patient is created using a barcode bracelet. The main component of the logistic support is the PDA, which uses the infrared technology to check the patient identity (barcode) supported by a wifi connection. This system allows to determine in real time the timing of all movements of the patient from ward to OR, and the identities of the team. The ORs Board decided to use the efficiency indicators defined by Dexter et al2: OR time of a case; Turnover time; Over-utilised OR time; Allocated OR time. In this way the patient is safe from risks; the ‘outcome’ becomes the possibility to check and make revisions of the whole ORs management process. The result of the first 18 months (January 2009 to December 2010) of activity is: 10495 surgical procedures recorded in 8 ORs; of which 85% is completed data. It is now possible to define what happens when ‘overutilised OR time’ becomes excessive or if it is necessary to schedule an additional case or if an ‘overbooking’ is necessary. The ‘determining optimum operating room utilisation’ can now be provided.
The results of the study were presented by the surgical unit board to the different department directors, which enabled an improved performance through shared, rather than the previously devolved, organisationalmanagement reviews. This real-time analysis system has increased the level of surgical activities (rate of occupation in the Operating Room) from 71% in 2009 to 79% in 2010. Meanwhile, the number of emergency procedures performed has been reduced from 25% to 16%, while at the same time maintaining the same level of complexity of operations performed. Through the implementation of this IT system, all stages of the surgical process have been made transparent and analysed in an objective manner, allowing the surgical unit board to implement actions to significantly improve performance.
|Award category:||smart public service delivery|
|Sector:||Public health and social welfare/affairs|
|Type of activity:|
|Keywords:||Innovation, ergonomics, effectiveness in healthcare, patient safety|
|Short English description:||They use a univocal identification of each operative room using a barcode image that is located on the main door of every OR and a univocal identification of each anaesthetic nurse using a Personal Digital Assistant.|
|Level of government:||local level|
|Size of organisation:||>100|
|Number of people involved:||6-10|
|EU membership:||EU member|