Improving Efficiency and Meeting Expectations Without Compromising Care on Trauma Surgical Rounds

Area of Science:

• Surgical Workflow Optimization
• Human-Centered Design in Healthcare
• Quality Improvement in Trauma Surgery

Background:

• Complex surgical services face competing demands requiring efficient quality improvement.
• Approaches must balance system and human needs with minimal resources.
• Trauma surgical rounds present unique challenges for care team efficiency.

Purpose of the Study:

• To demonstrate iterative prototyping's effectiveness in improving efficiency.
• To enhance system and stakeholder efficiency during daily trauma surgical rounds.
• To validate a human-centered design approach in a Level 1 trauma center.

Main Methods:

• Human-centered design used to develop and test prototypes for surgical rounding.
• Qualitative research informed iterative prototype development.
• Lean methodology time observations and tracking of intern work hours, operative starts, and discharge orders.

Main Results:

• Four prototypes were iteratively implemented, increasing care team satisfaction.
• Discharge order times decreased by 58 minutes; intern work hours reduced by 97 minutes/day.
• On-time operative starts increased from 40% to 63% (P < 0.05), with reduced clarification time.

Conclusions:

• Iterative prototyping within human-centered design effectively addresses complex healthcare systems.
• Rapid, in-context prototyping is feasible and beneficial for trauma surgical services.
• This methodology improves workflows and efficiency for healthcare systems and stakeholders.