Improving Surgical Patient Flow in a Congested Recovery Area

Improving Surgical Patient Flow in a Congested Recovery Area

Author: Trevor A. Schwartz

Publisher:

Published: 2012

Total Pages: 63

ISBN-13:

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The recent movement in healthcare reform requires hospitals to care for more patients while simultaneously reducing costs. Medical institutions can no longer afford to simply add beds and hire staff to increase capacity. They must use existing resources more effectively and develop innovative solutions to increase capacity. This project focuses on the redesign of surgical patient flow through multiple Post-Anesthesia Care Units (PACUs) at Massachusetts General Hospital (MGH). The PACU is where surgical patients recover following their procedure that takes place in the Operating Room (OR) suite. Some patients experience delays when leaving the OR due to the lack of a staffed PACU bed. These patients begin the recovery process in the OR which causes delays for to-follow cases. In addition, the OR nursing staff rather than a PACU nurse must monitor recovery, which drives higher costs and frustrates staff members. Therefore this study examined the sources of delay and sought to redesign the flow of surgical patients through the PACUs. Our main recommendation is to incorporate a "Fast Track" for the outpatient population that eliminates delays and expedites outpatient processing in the PACU. Segregating the outpatients and implementing the one-stop "Fast Track" recovery process will reduce average outpatient PACU length of stay (length of stay) by 27%, the equivalent of adding 1.8 beds of capacity. Through the application of operations management techniques, we can decrease the patient processing time or length of stay in the PACU, which in turn increases throughput and creates additional capacity.


Value-Based Care, An Issue of Anesthesiology Clinics

Value-Based Care, An Issue of Anesthesiology Clinics

Author: Lee A. Fleisher

Publisher: Elsevier Health Sciences

Published: 2016-01-07

Total Pages: 209

ISBN-13: 0323402372

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This issue will cover novel approaches to demonstrating value by anesthesiologists. Articles will include Value from the Patient and Payer Perspectives, Perioperative Surgical Home, Demonstrating Value: A British perspective, Demonstrating value: A case study of enhanced recovery, Acute Pain Management/Regional, Measuring Outcomes as Demonstrating Value and many more!


Optimizing Patient Flow

Optimizing Patient Flow

Author: Eugene Litvak

Publisher:

Published: 2018

Total Pages: 200

ISBN-13: 9781635850406

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Optimizing patient flow : advanced strategies for managing variability to enhance access, quality, and safety offers readers innovate techniques for maximizing patient flow and improving operations management while providing clear examples of successful impementation. This all-new book can help health care organizations to reduce and manage variability, thereby increasing the reliablity of systems and processes and improving health care quality and safety.


Lean Hospitals

Lean Hospitals

Author: Mark Graban

Publisher: CRC Press

Published: 2016-04-19

Total Pages: 260

ISBN-13: 1439870446

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Healthcare leaders around the world are facing tough challenges, including the need to deliver better value for patients and payers, which means improving quality while reducing cost. It might seem impossible to do both, but organizations around the world are proving it's possible, through Lean. Health systems are able to enhance all dimensions of patient care, including both safety and service, while creating more engaging and less frustrating workplaces for healthcare professionals and staff... all leading to improved long-term financial performance. Building on the success of the first two editions of this Shingo Prize-Winning book, Lean Hospitals: Improving Quality, Patient Safety, and Employee Engagement, Third Edition explains how to use the Lean philosophy and management system to improve safety, quality, access, and morale while reducing costs. Lean healthcare expert Mark Graban examines the challenges facing today’s health systems, including rising costs, falling reimbursement rates or budget constraints, employee retention, and harm to patients. The new edition of this international bestseller (translated into eight languages) begins with an overview of Lean methods and mindsets. It explains how engaging staff and leaders in Lean practices such as value stream mapping and process observation can help reduce wasted motion for caregivers, prevent delays for patients, and improve the long-term health of your organization. In addition to a new introduction from John Toussaint, this updated edition includes: New and updated material on identifying waste, A3 problem solving, employee idea management, kanban for materials management, and strategy deployment New case studies and examples—including a new 5S case study (Franciscan St. Francis Health) and other case examples highlighting the challenges and successes of an academic medical center and a small urgent access hospital, featuring quotes and stories from executives New examples and updated data throughout, including revised chapters on patient safety and patient flow challenges and the improvements driven by Lean Detailing the mindsets and methods needed for a successful transition to a Lean culture, the book provides the understanding of Lean practices—including value stream mapping, standardized work, error proofing, root cause problem solving, and daily improvement processes—needed to reduce common hospital errors and improve performance in other dimensions. The balanced approach outlined in this book will guide you through the process of improving the quality of care and service while reducing costs in your hospital. *The Lean Certification and Oversight Appeals committee has approved Lean Hospitals as recommended reading for those in pursuit of Lean Bronze Certification from SME, AME, Shingo Prize, and ASQ


Patient Flow

Patient Flow

Author: Randolph Hall

Publisher: Springer Science & Business Media

Published: 2013-12-11

Total Pages: 547

ISBN-13: 1461495121

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This book is dedicated to improving healthcare through reducing delays experienced by patients. With an interdisciplinary approach, this new edition, divided into five sections, begins by examining healthcare as an integrated system. Chapter 1 provides a hierarchical model of healthcare, rising from departments, to centers, regions and the “macro system.” A new chapter demonstrates how to use simulation to assess the interaction of system components to achieve performance goals, and Chapter 3 provides hands-on methods for developing process models to identify and remove bottlenecks, and for developing facility plans. Section 2 addresses crowding and the consequences of delay. Two new chapters (4 and 5) focus on delays in emergency departments, and Chapter 6 then examines medical outcomes that result from waits for surgeries. Section 3 concentrates on management of demand. Chapter 7 presents breakthrough strategies that use real-time monitoring systems for continuous improvement. Chapter 8 looks at the patient appointment system, particularly through the approach of advanced access. Chapter 9 concentrates on managing waiting lists for surgeries, and Chapter 10 examines triage outside of emergency departments, with a focus on allied health programs Section 4 offers analytical tools and models to support analysis of patient flows. Chapter 11 offers techniques for scheduling staff to match patterns in patient demand. Chapter 12 surveys the literature on simulation modeling, which is widely used for both healthcare design and process improvement. Chapter 13 is new and demonstrates the use of process mapping to represent a complex regional trauma system. Chapter 14 provides methods for forecasting demand for healthcare on a region-wide basis. Chapter 15 presents queueing theory as a method for modeling waits in healthcare, and Chapter 16 focuses on rapid delivery of medication in the event of a catastrophic event. Section 5 focuses on achieving change. Chapter 17 provides a diagnostic for assessing the state of a hospital and using the state assessment to select improvement strategies. Chapter 18 demonstrates the importance of optimizing care as patients transition from one care setting to the next. Chapter 19 is new and shows how to implement programs that improve patient satisfaction while also improving flow. Chapter 20 illustrates how to evaluate the overall portfolio of patient diagnostic groups to guide system changes, and Chapter 21 provides project management tools to guide the execution of patient flow projects.


Anesthesia for Otolaryngologic Surgery

Anesthesia for Otolaryngologic Surgery

Author: Basem Abdelmalak

Publisher: Cambridge University Press

Published: 2012-10-18

Total Pages: 371

ISBN-13: 1139789481

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Anesthesia for Otolaryngologic Surgery offers a comprehensive synopsis of the anesthetic management options for otolaryngologic and bronchoscopic procedures. Authored by world authorities in the fields of anesthesiology and otolaryngology, both theoretical concepts and practical issues are addressed in detail, providing literature-based evidence wherever available and offering expert clinical opinion where rigorous scientific evidence is lacking. A full chapter is dedicated to every common surgical ENT procedure, as well as less common procedures such as face transplantation. Clinical chapters are enriched with case descriptions, making the text applicable to everyday practice. Chapters are also enhanced by numerous illustrations and recommended anesthetic management plans, as well as hints and tips that draw on the authors' extensive experience. Comprehensively reviewing the whole field, Anesthesia for Otolaryngologic Surgery is an invaluable resource for every clinician involved in the care of ENT surgical patients, including anesthesiologists, otolaryngologists and pulmonologists.


Oral and Maxillofacial Surgery for the Clinician

Oral and Maxillofacial Surgery for the Clinician

Author: Krishnamurthy Bonanthaya

Publisher: Springer Nature

Published: 2021

Total Pages: 1965

ISBN-13: 9811513465

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This is an open access book with CC BY 4.0 license. This comprehensive open access textbook provides a comprehensive coverage of principles and practice of oral and maxillofacial surgery. With a range of topics starting from routine dentoalveolar surgery to advanced and complex surgical procedures, this volume is a meaningful combination of text and illustrations including clinical photos, radiographs, and videos. It provides guidance on evidence-based practices in context to existing protocols, guidelines and recommendations to help readers deal with most clinical scenarios in their daily surgical work. This multidisciplinary textbook is meant for postgraduate trainees, young practicing oral surgeons and experienced clinicians, as well as those preparing for university and board certification exams. It also aids in decision-making, the implementation of treatment plans and the management of complications that may arise. This book is an initiative of Association of Oral and Maxillofacial Surgeons of India (AOMSI) to its commitment to academic medicine. As part of this commitment, this textbook is in open access to help ensure widest possible dissemination to readers across the world. ; Open access Unique presentation with contents divided into color-coded core competency gradations Covers all aspects of oral and maxillofacial surgery Supplemented with videos of all commonly carried out procedures as operative video Every chapter or topic concludes with "future perspective" and addresses cutting edge advances in each area Every topic has a pull out box that provides the most relevant systematic reviews/ key articles to every topic.


Fundamental Orthopedic Management for the Physical Therapist Assistant - E-Book

Fundamental Orthopedic Management for the Physical Therapist Assistant - E-Book

Author: Robert C. Manske

Publisher: Elsevier Health Sciences

Published: 2021-07-15

Total Pages: 638

ISBN-13: 0323661726

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NEW! Updated content and references are added throughout the book to reflect changes in practice patterns. NEW! Expanded full-color illustrations add clarity to anatomy and procedural drawings and make it easier to learn important concepts NEW! Updated chapter summaries highlight essential, need-to-know information. NEW! Updated educator and student resources on the Evolve website provide tools to make teaching and learning easier.


The High-risk Surgical Patient

The High-risk Surgical Patient

Author: Paolo Aseni

Publisher: Springer Nature

Published: 2023-03-07

Total Pages: 952

ISBN-13: 3031172736

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It is well known that certain diseases and patient conditions are associated with increased perioperative risk. The aim of this book is to define and identify the clinical factors that warrant a broader and more detailed assessment of pre-operative surgical risk in difficult and unusual clinical settings. One of the sections is dedicated to the main pathway of peri- and post-surgical critical care based on the patient-specific deterioration risk and associated diseases; here, a panel of selected experts describes the correct patient-oriented pathways for complex or unscheduled surgical operations in order to reduce the operative risk. In addition, the book describes the latest trends in minimally invasive surgical techniques that are associated with peri- and post-operative risk reduction, and provides an overview of recent advances in surgical simulation, focusing on perspectives in surgical research to increase patient safety. Guidance is also provided on extracorporeal membrane oxygenation (ECMO), Left Ventricular Assist Devices (LVADs), and their management in patients requiring emergency surgery. The book will help surgical trainees recognize cases with the highest surgical risk and identify the most common complications at an early stage.