Improving timely transplantation while reducing cancellation of scheduled surgery

Area of Science:

• Transplant Surgery
• Healthcare Operations Management
• Quality Improvement Initiatives

Background:

• Organ transplant programs face resource strain due to urgent cases, often leading to scheduled surgery cancellations.
• A quality-improvement initiative was undertaken at a major North American multi-organ transplant center (Toronto General Hospital, University Health Network).
• The initiative adapted a system developed by the Institute for Healthcare Optimization to manage perioperative resources.

Purpose of the Study:

• To assess the impact of the University Health Network Institute for Healthcare Optimization system on transplant program efficiency.
• To evaluate changes in operating room resource utilization and access to transplantation.
• To determine if the new system could accommodate increased transplant volumes without disrupting other surgical services.

Main Methods:

• A retrospective, before-and-after, single-center study design was employed.
• The University Health Network Institute for Healthcare Optimization system involved dedicating two operating rooms for urgent/emergency cases and formalizing transplant urgency classification.
• Data on surgery cancellations, operating room access times, after-hours transplantation, and case completion rates were analyzed.

Main Results:

• A significant reduction in monthly surgical cancellations was observed (3% vs 9%, P < .001).
• Transplant recipients demonstrated improved access to the operating room within target times across all organ types (P < .001).
• No increase in after-hours transplantation or decrease in monthly completed cases was noted (P = .684).

Conclusions:

• The University Health Network Institute for Healthcare Optimization system successfully improved operating room resource management.
• The implemented system enabled the center to handle increased organ transplant volumes.
• This initiative demonstrated that enhanced operational efficiency can be achieved without negatively affecting other surgical services.