Imagine if only 30 percent of BWI’s first flights of the day took off on time. Commercial aviation is a large complex system. If 70% of flights from Baltimore arrived at their destinations late, it wouldn’t be long before the whole country was getting behind. Imagine how many upset travelers there would be. Imagine, also, the pressure on the air traffic controllers as they had to delay other flights to allow late flights to land.
We know that the hospital is also one large, complex system. If the operating room is sending cases out late, the PACU (Post Anesthesia Care Unit) will be delayed and cases will arrive to their inpatient beds (or outpatients to their homes) behind schedule. The downstream staff will be overwhelmed and people will have to stay longer than anticipated. The hospital will have to pay overtime to many or ask more staff to come in to handle the load. Subsequent operating room cases will start and end after their scheduled timeslots and some patients who have been fasting since the previous midnight will need to fast longer. No one is happy.
It is not easy to make sure that everything is ready to go on time in all operating rooms in a surgical suite. Team members can arrive late, the patients can arrive late, there can be missing lab work that is required to assure that the surgery can be done safely, or the patient may be nervous and want to ask a few more last minute questions. But studying the reasons why cases are late and using problem solving to test changes will result in more on-time first cases. This is just what our Sherwood Outpatient Surgery Center Team has done under the leadership of its medical director, Dr. Aaron Wood, and its Clinical Unit Coordinators, Holly Clevenger, RN and Kate Devan, RN3 BSN, CAPA. This team selected first case on-time starts as one of their Least Waste metrics for Lean Daily Management and they have tested many changes and made great progress. You see from the run chart below that in March they had over 70% late first case starts and that number is now down to 34%. They have reduced the defect rate by more than 50% !
Team members understand that cases start late most frequently because of the system for getting ready, so they continue to study their system and ask the “why” questions when one does not start on time. I am so proud of them and I am very grateful for all of their hard work.
Congratulations to our Chairman of Radiation Oncology, Robert K. Brookland, M.D., who earlier this week was honored with the Martin D. Abeloff Award for Excellence in Public Health and Cancer Control by the Maryland State Council on Cancer Control. For those who don’t know, this award is given annually to a Marylander who has contributed to reducing the incidence, morbidity and mortality of cancer through research focused on cancer control. Dr. Brookland is a great leader at GBMC and we are proud of him for earning this prestigious honor. Please congratulate him the next time you see him!
While on the topic of significant recognitions,
I am so pleased to announce that our hospital was named Top Performer on Key Quality Measures® for 2013 by The Joint Commission, the leading accreditor of health care organizations in America.
This is a big deal because less than one-third of U.S. hospitals earn this distinction. According to The Joint Commission, we were chosen for “our commitment to assuring that evidence-based intentions are delivered in the right way at the right time – because it’s the right thing to do for your patients.” I want to thank the following individuals and teams for helping us attain this major achievement: Carolyn Candiello, Vice President of Quality and Patient Safety, the executive sponsor for the Core Measure reporting, Michele Cave, BSN, RN (Director of Clinical Quality Outcomes), Laura Hines, RN, Sara Helman, RN, and Laura Wieber.
The following nurse leaders also contributed: Lindsey Cromwell-Rims, RN (Nurse Manager of IR and the Kroh Center), Stephanie Topscher, RN (Clinical Director ED/UC), Charlene Mahoney, RN (Nurse Manager PACU), along with physician champions: Jeff Sternlicht, MD (Chairman, ED), Reed Riley, MD (Chief of Cardiology), Jack Flowers, MD (Chairman, Surgery), and all of our outstanding physicians, nurses and other clinicians. Thank you for all you do for our patients.
I am truly proud of this recognition as it clearly demonstrates that we are moving toward our vision of treating everyone the way we want our own loved ones treated. We are pleased that the Joint Commission has recognized us as one of their “top performers” on key quality measures.