Transforming orthopaedic theatres l.jpg
This presentation is the property of its rightful owner.
Sponsored Links
1 / 16

Transforming Orthopaedic Theatres! PowerPoint PPT Presentation


  • 211 Views
  • Uploaded on
  • Presentation posted in: General

Transforming Orthopaedic Theatres! . Alison Todd Lean Project Manager. Context. NHS Borders – 110,000 population 5 theatres 1 orthopaedic theatre 5 orthopaedic surgeons Activity – 340 joints per year. Problems. 20% Shortfall in orthopaedic capacity £550,000 cost of send-aways

Download Presentation

Transforming Orthopaedic Theatres!

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


Transforming orthopaedic theatres l.jpg

Transforming Orthopaedic Theatres!

Alison Todd Lean Project Manager


Context l.jpg

Context

  • NHS Borders – 110,000 population

  • 5 theatres

  • 1 orthopaedic theatre

  • 5 orthopaedic surgeons

  • Activity – 340 joints per year


Problems l.jpg

Problems

  • 20% Shortfall in orthopaedic capacity

  • £550,000 cost of send-aways

  • Average knife-to skin time: 09.50

  • Inefficiencies in our processes reducing available operating time

  • Poor compliance with Patient Safety Programme recommendations


Slide4 l.jpg

Aim

  • maximise orthopaedic theatre efficiency

  • minimise lost operating time at start of theatre lists (knife to skin 9am)

  • reduce unnecessary surgical bed days

  • address issues related to Patient Safety Programme implementation

  • increase team working


Slide5 l.jpg

Lean

  • Process – eliminates waste

    adds value to the patient

    Improves performance

    patient is key

  • Tool kit

  • A way of working

  • Empowers staff


Staff buy in l.jpg

Staff buy in

  • Communication/ Lean awareness sessions

  • Project Team

  • Senior management support throughout the project


Slide7 l.jpg

The Project Framework

Project Timeline

VSM

Kaizen

(incl. logistics)

Preparation work

(Including Training)

Sustainability


What we found l.jpg

What we found…

  • Inaccurate data on operation lists

  • 30-50% of operating lists changes on day of surgery

  • 45% were changes to the order of the lists

  • Poor communication between the ward and theatres incurring delays

  • Variation in downtime between procedures

  • Equipment / radiology conflict

  • Frequent overrunning of lists


Key changes and actions l.jpg

Key changes and actions

List reconstruction

4 weeks before:-

Patient listed and pre-assessment booked

2 weeks before:-

Pre-assessment

48 hrs before:-

List locked down on sapphire management system


New theatre list change mgt system l.jpg

New Theatre List Change Mgt System


Key changes l.jpg

Key changes

Improved start times

  • Adapted staff rotas to reflect changes

    Turnaround time (End surgery to knife to skin )

  • Enhanced communication with orthopaedic ward

  • Improved patient transfer from ward to theatre

  • Reduced number of handovers from 6 → 3

    Patient safety

  • No entry sign!


What we achieved l.jpg

What we achieved


Multidisciplinary team effort l.jpg

Multidisciplinary team effort

The whole process works amazingly well. It was a pleasure to do the list and all seemed extremely well organised. Anaesthetist

“Often I can wait 10 minutes between patients, today I did not wait at all” Peri-operative staff

Bring me my 4th joint, an absolute bloody pleasure to be part of this!” Orthopaedic Surgeon


Still to do l.jpg

Still to do…

  • Same day admission for all arthroplasty demonstrated but not sustained (400 bed days/year)

  • Anaesthetic input pre-assessment process

  • Downstream flow (discharges)

  • Staff development - Physician Assistant Anaesthesia

    - Advanced scrub practitioners

  • Increase productivity to 4 joints per list


Slide15 l.jpg

Lean Delivers?

4 theatres leaned including emergency theatre

Main conclusions

  • Lean works!

  • Hard work and tears! BUT huge staff engagement and enthusiasm

  • Impressive changes – but consistency is major win


Questions l.jpg

Questions?


  • Login