Children's Hospitals Today - Spring 2023 - 26

FEATURE / IMPROVEMENT
UROLOGY OUTPATIENT SURGERY
MORE CASELOADS, SAME QUALITY
PAUL MERGUERIAN, M.D.,
chief of urology, wanted to
increase monthly case volumes
at the ambulatory surgery
center without a change
in staffing or increase in
overtime. Working backwards,
he developed a framework:
to increase daytime capacity,
they needed to use the OR
time more efficiently, without
sacrificing quality. They
leveraged a non-traditional
metric, surgery prep time.
This is the interval between
anesthesia readiness and
surgical start time that
includes patient positioning,
skin prep, draping the surgical
field, and performing a safety
time out. The urology team's
average surgery prep time
was 13.8 minutes. Using data,
Merguerian identified two
surgeons who consistently
completed surgery prep time
30% faster. These surgeons
had a different workflow with
seemingly simple behaviors
that saved minutes. They were
consistently present in the OR
as the patient arrived, helped
transfer and position the
patient on the OR table, and
insisted their resident assist.
They prepped the skin with
iodine instead of chlorhexidine,
eliminating the need for a
three-minute dry time.
The entire urology group
was able to save nearly four
minutes per patient. That
translated to an extra case
per operating day, increasing
monthly urology surgical
volumes from 70 cases a
month to 94 cases a month.
Baseline surgical site infection
rate was less than 0.1%
throughout this improvement
project. The additional
increase in capacity resulted
in $2.5 million in institutional
revenue per year.
BY THE NUMBERS
4
minutes saved
on each patient
24
additional cases
per month
$2.5 million
in revenue
SUCCESS STRATEGIES
Create a winning
gameplan
Follow Seattle's Children's
improvement process to
achieve similar results.
Define the data that
truly matters.
Identify high-performing
outliers among individual staff.
26
CHILDREN'S HOSPITALS TODAY Spring 2023

Children's Hospitals Today - Spring 2023

Table of Contents for the Digital Edition of Children's Hospitals Today - Spring 2023

Contents
Children's Hospitals Today - Spring 2023 - Cover1
Children's Hospitals Today - Spring 2023 - Cover2
Children's Hospitals Today - Spring 2023 - Contents
Children's Hospitals Today - Spring 2023 - 2
Children's Hospitals Today - Spring 2023 - 3
Children's Hospitals Today - Spring 2023 - 4
Children's Hospitals Today - Spring 2023 - 5
Children's Hospitals Today - Spring 2023 - 6
Children's Hospitals Today - Spring 2023 - 7
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Children's Hospitals Today - Spring 2023 - 11
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Children's Hospitals Today - Spring 2023 - 13
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Children's Hospitals Today - Spring 2023 - 15
Children's Hospitals Today - Spring 2023 - 16
Children's Hospitals Today - Spring 2023 - 17
Children's Hospitals Today - Spring 2023 - 18
Children's Hospitals Today - Spring 2023 - 19
Children's Hospitals Today - Spring 2023 - 20
Children's Hospitals Today - Spring 2023 - 21
Children's Hospitals Today - Spring 2023 - 22
Children's Hospitals Today - Spring 2023 - 23
Children's Hospitals Today - Spring 2023 - 24
Children's Hospitals Today - Spring 2023 - 25
Children's Hospitals Today - Spring 2023 - 26
Children's Hospitals Today - Spring 2023 - 27
Children's Hospitals Today - Spring 2023 - 28
Children's Hospitals Today - Spring 2023 - 29
Children's Hospitals Today - Spring 2023 - 30
Children's Hospitals Today - Spring 2023 - 31
Children's Hospitals Today - Spring 2023 - 32
Children's Hospitals Today - Spring 2023 - Cover3
Children's Hospitals Today - Spring 2023 - Cover4
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