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Improving Surgical Start Times by Improving Wayfinding
Esther Lee1, JoAnn Daugherty2, Joanne T Selga1
1Perianesthesia Services, UC San Diego Health, San Diego, CA.
Summary
Implementing clear signage significantly reduced patient delays in finding the preoperative area, leading to more punctual operating room (OR) starts. This performance improvement project highlights the impact of improved wayfinding on surgical scheduling efficiency.
Area of Science:
- Healthcare Operations Management
- Patient Flow Optimization
- Surgical Services Improvement
Background:
- Costly delays in first-case operating room (OR) start times negatively impact surgical efficiency and patient care.
- Patient wayfinding challenges within healthcare facilities can contribute to missed appointments and procedural delays.
- Performance improvement initiatives are crucial for addressing operational bottlenecks in hospital settings.
Purpose of the Study:
- To reduce costly delays in first-case operating room (OR) start times through a targeted performance improvement project.
- To identify and mitigate factors contributing to patient delays in accessing the operating room suite.
- To evaluate the effectiveness of signage implementation on patient navigation and OR start times.
Main Methods:
- Two Plan-Do-Study-Act (PDSA) cycles were employed to systematically address and evaluate the intervention.
- PDSA Cycle 1 involved direct patient observation (n=30) to map travel paths and identify key delay points, particularly in locating the preoperative area (POA).
- PDSA Cycle 2 utilized electronic medical record (EMR) data (n=492 pre-signage, n=538 post-signage) to quantitatively assess the impact of newly placed directional signage on POA arrival times.
Main Results:
- Initial observations identified patient difficulty in locating the preoperative area (POA) as a significant cause of delay.
- Following the strategic placement of directional signage, median patient arrival times at the POA decreased significantly from 34 minutes to 20 minutes (U=51,618.0, z=-16.934, P<.001).
- The implemented signage intervention demonstrated a measurable improvement in patient navigation efficiency.
Conclusions:
- Delayed patient wayfinding was a contributing factor to delayed operating room (OR) start times.
- The implementation of appropriate and strategic signage effectively improved patient navigation to the preoperative area.
- Targeted interventions addressing patient flow and wayfinding can lead to enhanced operational efficiency in surgical settings.
