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Journal cover: International Journal of Health Care Quality Assurance

International Journal of Health Care Quality Assurance

ISSN: 0952-6862

Online from: 1988

Subject Area: Health Care Management/Healthcare

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On the day of surgery: how long does preventable disruption prolong the patient journey?

Document Information:
Title:On the day of surgery: how long does preventable disruption prolong the patient journey?
Author(s):Latif Al-Hakim, (University of Southern Queensland, Toowoomba, Queensland, Australia), Xiao Yan Gong, (University of Southern Queensland, Toowoomba, Queensland, Australia)
Citation:Latif Al-Hakim, Xiao Yan Gong, (2012) "On the day of surgery: how long does preventable disruption prolong the patient journey?", International Journal of Health Care Quality Assurance, Vol. 25 Iss: 4, pp.322 - 342
Keywords:Australia, Coordination, Customer services quality, Disruption, Lean thinking, Operating room, Patient care, Process efficiency, Surgery
Article type:Research paper
DOI:10.1108/09526861211221509 (Permanent URL)
Publisher:Emerald Group Publishing Limited
Acknowledgements:This research is part of a project titled “Adapted lean thinking for healthcare services”. The project has been partially sponsored by the University of Southern Queensland and approved by the Human Research Ethic Committee, Toowoomba and Darling Downs Health Service District (HREC 2007/027). The author thanks anonymous reviewers for their insightful comments, which have greatly improved the paper. The authors are grateful to Senior Anaesthetist Dr Nicole Fairweather (University of Queensland) for her time, support and involvement in this project. The authors gratefully acknowledges the thoughtful time of Queensland Health Project Liaison Officer Ms Sylvia Johnson and other professionals who participated in this study.

Purpose – Disruption considerably prolongs session times for surgery, affects the quality of patient care, and prolongs waiting lists. In addition, there is a strong relationship between disruption and surgical error. This research aims to provide a platform for healthcare services to identify the sources of preventable disruption affecting operative time within the perioperative process and to effectively reduce it.

Design/methodology/approach – Events inside and outside operating rooms that disturb the operative time were recorded for 31 elective surgeries over the period of five months. Disruption events were classified according to the hospital's requirements and the findings were reviewed by the surgical teams. Lean thinking approaches were used to achieve the purpose of this study.

Findings – Preventable disruption caused an increase in surgical time of approximately 25 per cent. Preventable disruption consisted of poor information flow, failure to follow concepts of methods study, lack of communication and lack of coordination. Coordination failures were the main reason for disruption followed by the lack of following the principles of motion economy.

Originality/value – Surgical disruption has substantial financial implications for hospitals. This research indicates that it is possible to reduce operative time considerably by eliminating preventable disruption. Such additional time could be utilised to deal with the pressure of emergency cases, reduce the waiting lists for elective surgery, increase operating room utilisation, and reduce medical errors.

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