The Role of Organizational Culture in Operating Room Turnaround Time.

David Ninan,Amanda Kore,Barbara Ninan,Elizabeth Wasson,Tricia Fullerton,Janet Zhu

doi:10.7759/cureus.1257

Abstract

This analysis looks at the application of a robust process improvement methodology to achieve a sustained organizational change. The implementation took place in a safety net hospital’s operating suites that had a problem with relatively long, nonproductive turnover times between surgical procedures. Organizational leadership empowered stakeholders to use Lean and Six-Sigma tools to develop more efficient organizational processes. These processes were then implemented in a phased approach with careful attention to the organization’s culture. The result was a significant reduction in turnover times leading to greater operational efficiency.

Highlights

The US health care system consumes a disproportionate amount of the nation’s resources
In a push to transform health care safety, The Joint Commission has developed a set of resources called High-Reliability Organizational Assessment and Resources tools available on their website
The team wanted a clearly defined measurement specific to their performance and chose to exclude all factors outside the control of anesthesia or nursing. For this reason, prolonged turnover time (TOT)’s were excluded if they were due to factors such as the patient or surgeon being late on arrival or emergent operations where the staff did not have time to prepare in advance

Summary

Introduction

The US health care system consumes a disproportionate amount of the nation’s resources. This report looks at how one organization struggled to improve efficiency and was successful by implementing a culturally focused change process While this exercise took place in an operating suite, the techniques and strategies employed are universal and can be applied in many other settings. The process began by mapping out the current flow of operations between surgeries They looked for areas of redundancy and eliminated aspects such as multiple teams asking the patient the same questions (unless it was safety related). The team wanted a clearly defined measurement specific to their performance and chose to exclude all factors outside the control of anesthesia or nursing For this reason, prolonged TOT’s were excluded if they were due to factors such as the patient or surgeon being late on arrival or emergent operations where the staff did not have time to prepare in advance. It is possible that the approach of the leadership to provide individualized attention to the staff helped them feel like valued team members, helping them be more open to change

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Disclosures