OR Manager - July 2019 - 20

Performance improvement
Continued from page 19
it to a data bank, and then create and
build their own calculations.
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This begins with ETL, which combines
three database functions-extract,
transform, load-into one tool to
pull data out of one database and place
it into another.
" ETL is very important and takes the
longest amount of time to create, " says
Puncochar. " IT specialists are pulling
the data out, making sure it is formatted
correctly, and then moving it into an
enterprise data warehouse [EDW]. " This
component takes 60% to 80% of the
work in IT. " Think of this as similar to
the transplant surgery steps of recover/
harvest, transport, and graft, " he says.
The EDW is a central repository optimized
for analytics that connects the
dots with human resources staffing
data, financial data, and quality data
(sidebar, p 19, bottom). Instead of accessing
five different reports to pull
something together, the EDW has everything
in one spot.
" It's like having a shopping cart and
saying, 'I need this metric, and this
metric, and this metric.' It helps you to
know what's on your radar, " he says.
Puncochar likes to start out with the
concept of: " We need to put all the information
we may need into the EDW so
we can run any report we want. "
Reports include:
* new or ad hoc reports or metrics
on surgeons and nurses by specialty,
for example, what percentage
of cases are trauma cases, or how
many trauma cases are performed
each year
* dimension report or standard lists
of patient type, case type, surgeon,
staff
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OR Manager | July 2019
20
* drill report that drills down to the
case level details used to calculate
and prove the numbers or results
* metadata report that includes definitions
and instructions about the
data or instructions for use
6/12/17 2:15 PM
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* a slice report that breaks down a
metric into an area of interest by
dimension, such as first case starts
by surgeon.
'Help me help you'
" Just like the line in the movie Jerry
Maguire, 'Help me help you,' we need
to help IT help us and vice versa, " says
Puncochar. To help IT specialists build
the reports and dashboards they want,
he suggests OR managers do the following:
*
include examples of patient type (inpatient,
outpatient) and case type
(urgent, emergent, planned)
* include screenshots of EMR screens
* provide examples of custom reports
and graphs created in Excel or other
tools
* start with an Excel file of real data
and work with a business or data analyst
to create sample calculations
* provide guidance on how often and
quickly you need the data (real time
is expensive, daily may be good
enough, and monthly is least expensive).
Puncochar
also recommends that OR
managers ask IT specialists to make
rounds with them. " You can start educating
them on patient flow from admission
to the preoperative area, into the
OR, and then to the postanesthesia
care area, " he says.
" Once IT knows our world in the
OR and as long as the data is available,
they can tap, drag, drop, and slice
any information we want, give it to us
quickly, and keep it in the middle of our
radar screens. " ✥
-Judith M. Mathias, MA, RN
References
Puncochar J, Lusk K F. What airlines
have in common with the OR. AORN
Leadership Summit. 2019.
Sullenberger C, Chesley B. 'Sully' Sullenberger:
making safety a core
business function. Healthc Financ
Manage. 2013;67:50-54.
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OR Manager - July 2019

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