Quality Improvement of Surgical Team Communication of Required Percutaneous Nephrolithotomy Equipment

Abstract

To evaluate if implementation of a percutaneous nephrolithotomy (PCNL) equipment whiteboard can improve communication accuracy of surgical equipment, streamline operative efficiency, and decrease unnecessary case equipment costs. A real time editable equipment whiteboard was designed and implemented for all PCNL cases between October and December 2021. The relative difference in pre- and post-intervention surgical equipment accuracy as well as overall case costing was compared from 90 days prior to implementation to the period after intervention. Quality assessment surveys were completed prior to whiteboard implementation (N=25) and ost-implementation (n=15). Pre- and post-operative assessment of equipment communication, assessed on a 10-point scale, improved after implementation of the communication whiteboard (Pre-op: 6.7/10 vs. 8.9/10, p<0.001. Post-op: 7.0/10 vs. 9.3/10, p<0.001). On average 64% (3.2/5) of items were accurate on pre-intervention cases. Post-intervention accuracy improved to 88% (4.4/5 items) (p=0.049). There was a significant relative case cost improvement after implementing the PCNL equipment whiteboard with an average of $436.81 USD savings per case (p=0.001) and $488.22 USD per renal moiety (p=0.002). Our baseline quality assessment of surgical team communication regarding PCNL equipment identified an area for improvement. Multidisciplinary feedback resulted in the development of a real time editable PCNL equipment whiteboard which improved team perception of equipment communication, case item accuracy and resulted in a relative average cost savings for PCNL.