Perioperative Efficiency vs. Quality of Care – Do We Always Have to Choose?
Introduction: ATTEMPTS to enforce optimization practices for operating room (OR) efficiency are often interpreted as a “pressure for production” which threatens patient safety. The aim of this study is to assess if and how improvements in OR efficiency affect patient safety and thus the quality of c...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2020-03-01
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| Series: | Journal of Investigative Surgery |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/08941939.2018.1492049 |
| _version_ | 1797684703451414528 |
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| author | Mikhail Chernov Angela Vick Sujatha Ramachandran Shamantha Reddy Galina Leyvi Ellise Delphin |
| author_facet | Mikhail Chernov Angela Vick Sujatha Ramachandran Shamantha Reddy Galina Leyvi Ellise Delphin |
| author_sort | Mikhail Chernov |
| collection | DOAJ |
| description | Introduction: ATTEMPTS to enforce optimization practices for operating room (OR) efficiency are often interpreted as a “pressure for production” which threatens patient safety. The aim of this study is to assess if and how improvements in OR efficiency affect patient safety and thus the quality of care. Methods: In an attempt to optimize OR efficiency, a new OR management approach “Integrated Practice Improvement Solutions” (IPIS) was developed at the Weiler Division of Montefiore Medical Center in 2011. IPIS is a flexible managerial system based on elements of multiple practice improvement methodologies incorporated into an open source framework. It was implemented in 2012. The data presented covers the period from 2012 through 2014 when the system was temporarily discontinued due to administrative restructuring. Data from 2011 was used as a baseline. The impact of IPIS on patient safety and quality of care was assessed based on quality improvement and patient safety (QIPS) Committee reports covering the same period of time. Results: IPIS implementation resulted in an increase in surgical workload by an average of 10.7%, an increase in OR and anesthesia revenues by 18.5% and 6.9%, respectively, and decreases in turnover time by 15% and overtime for the anesthesia staff by 26%. Based on QIPS reports, the total number of complications potentially attributable to “production pressure” was 0.25%, 0.2% and 0.16% in 2012, 2013 and 2014, respectively compared to 0.21% in 2011 (p = 0.56). Conclusions: Gradual implementation of a methodologically structured improvement in OR efficiency has no negative impact on patient safety and quality of care. |
| first_indexed | 2024-03-12T00:34:33Z |
| format | Article |
| id | doaj.art-d686375dbc6d4a429a3d806025be4588 |
| institution | Directory Open Access Journal |
| issn | 0894-1939 1521-0553 |
| language | English |
| last_indexed | 2024-03-12T00:34:33Z |
| publishDate | 2020-03-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Investigative Surgery |
| spelling | doaj.art-d686375dbc6d4a429a3d806025be45882023-09-15T10:07:28ZengTaylor & Francis GroupJournal of Investigative Surgery0894-19391521-05532020-03-0133326527010.1080/08941939.2018.14920491492049Perioperative Efficiency vs. Quality of Care – Do We Always Have to Choose?Mikhail Chernov0Angela Vick1Sujatha Ramachandran2Shamantha Reddy3Galina Leyvi4Ellise Delphin5Montefiore Medical Center, AnesthesiologyMontefiore Medical Center, AnesthesiologyMontefiore Medical Center, AnesthesiologyMontefiore Medical Center, AnesthesiologyMontefiore Medical Center, AnesthesiologyMontefiore Medical Center, AnesthesiologyIntroduction: ATTEMPTS to enforce optimization practices for operating room (OR) efficiency are often interpreted as a “pressure for production” which threatens patient safety. The aim of this study is to assess if and how improvements in OR efficiency affect patient safety and thus the quality of care. Methods: In an attempt to optimize OR efficiency, a new OR management approach “Integrated Practice Improvement Solutions” (IPIS) was developed at the Weiler Division of Montefiore Medical Center in 2011. IPIS is a flexible managerial system based on elements of multiple practice improvement methodologies incorporated into an open source framework. It was implemented in 2012. The data presented covers the period from 2012 through 2014 when the system was temporarily discontinued due to administrative restructuring. Data from 2011 was used as a baseline. The impact of IPIS on patient safety and quality of care was assessed based on quality improvement and patient safety (QIPS) Committee reports covering the same period of time. Results: IPIS implementation resulted in an increase in surgical workload by an average of 10.7%, an increase in OR and anesthesia revenues by 18.5% and 6.9%, respectively, and decreases in turnover time by 15% and overtime for the anesthesia staff by 26%. Based on QIPS reports, the total number of complications potentially attributable to “production pressure” was 0.25%, 0.2% and 0.16% in 2012, 2013 and 2014, respectively compared to 0.21% in 2011 (p = 0.56). Conclusions: Gradual implementation of a methodologically structured improvement in OR efficiency has no negative impact on patient safety and quality of care.http://dx.doi.org/10.1080/08941939.2018.1492049operating room efficiencyquality of patients carepractice improvement methodologiesproduction pressurequality improvementperioperative management |
| spellingShingle | Mikhail Chernov Angela Vick Sujatha Ramachandran Shamantha Reddy Galina Leyvi Ellise Delphin Perioperative Efficiency vs. Quality of Care – Do We Always Have to Choose? Journal of Investigative Surgery operating room efficiency quality of patients care practice improvement methodologies production pressure quality improvement perioperative management |
| title | Perioperative Efficiency vs. Quality of Care – Do We Always Have to Choose? |
| title_full | Perioperative Efficiency vs. Quality of Care – Do We Always Have to Choose? |
| title_fullStr | Perioperative Efficiency vs. Quality of Care – Do We Always Have to Choose? |
| title_full_unstemmed | Perioperative Efficiency vs. Quality of Care – Do We Always Have to Choose? |
| title_short | Perioperative Efficiency vs. Quality of Care – Do We Always Have to Choose? |
| title_sort | perioperative efficiency vs quality of care do we always have to choose |
| topic | operating room efficiency quality of patients care practice improvement methodologies production pressure quality improvement perioperative management |
| url | http://dx.doi.org/10.1080/08941939.2018.1492049 |
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