MP16-02 INFLUENCE OF INTERDEPARTMENTAL COLLABORATION ON UTILIZATION OF NEOADJUVANT CHEMOTHERAPY PRIOR TO CYSTECTOMY; A 14-YEAR EXPERIENCE

Abstract

INTRODUCTION AND OBJECTIVES: TeamSTEPPS is a collaborative effort by the Department of Defense and Agency for Healthcare Research and Quality to improve performance and patient safety in the healthcare environment. A commonly stated barrier to implementation of TeamSTEPPS is the time requirement of healthcare personnel during a busy operative schedule and the perceived consequential adverse effect on operating room efficiency. The purpose of this project is to evaluate the operating room efficiency during the first year of implementation of TeamSTEPPS compared to the prior year in the Department of Urology at a teaching medical center. METHODS: TeamSTEPPS consisted of an initial one-time personnel training session, preoperative briefings at the beginning of each day for each operating room, and postoperative debriefings after each case. The preoperative briefing was led by the surgeon and attended by all healthcare personnel assigned to the specific operating room to discuss concerns unique to each case scheduled for that day. Postoperative debriefings identified areas for improvement. The operative times, on-time start rates, and turnover times of all cases performed by the Department of Urology during the year with TeamSTEPPS were compared to the prior year before implementation of TeamSTEPPS. RESULTS: A total of 1431 cases with TeamSTEPPS and 1513 cases before TeamSTEPPS were compared. Case complexity and distribution among subspecialties were similar between the years with and before TeamSTEPPS. The mean in-room to turnover-to-surgeon time was 13.75 minutes with TeamSTEPPS compared to 14.45 minutes before TeamSTEPPS (p1⁄40.017). The mean turnover-to-surgeon to surgical-start timewas15.19minuteswith TeamSTEPPSand16.29minutes before TeamSTEPPS (p1⁄40.004). The mean surgical time with TeamSTEPPS was 72.23 minutes compared to 83.45 minutes before TeamSTEPPS (p<0.001). The on-time first-start rate was 69.8% with TeamSTEPPS while the rate before TeamSTEPPS was 48.9% (p<0.001). The mean room turnover time of 40.49 minutes with TeamSTEPPS was not significantly different than the before TeamSTEPPS time of 41.48 minutes (p1⁄40.193). CONCLUSIONS: The time requirement by healthcare personnel to participate in daily TeamSTEPPS briefings does not adversely affect operating room efficiency. TeamSTEPPS improves operating room efficiency by decreasing operating room time and increasing on-time first-start rates.