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On our way to The Productive Operating Theatre
Vancouver Coastal Health Authority
Felicia Laing – Quality and Patient SafetyAndra Grigore – RN Perioperative Services, LGH
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Key Areas of Focus
• What is The Productive Operating Theatre?• Knowing How We Are Doing• Well Organized Theatre • Team-Working• Operational Status At A Glance
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The Productive Operating Theatre
• A modular improvement program developed by NHS UK
• A structured way of approaching challenges and opportunities specific to our OR team
• Tools to improve communication between front line staff and senior leadership
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Productive Series Sites
TPOT Modules
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TPOT AIM
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Lions Gate Hospital
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Before TPOTNo common goal or visionPoor communicationDisorganized Operating RoomsMinimal team-buildingLimited quality improvement
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Knowing How We Are Doing
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• Set objectives• Measure how we
are doing across the 4 domains of quality
• PDSA and sustain
Visioning Workshop
• Staff discussed barriers to perfect work day
• Nurses, Surgeons, Anaesthetists, Periop Aides, Anaesthetic Assistant
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Themes and Dot-Voting
• Themes similar across ORs
• Essential for high functioning & reliable ORs
• Physicians voted for efficiency themes
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Vision Statement
“The LGH Perioperative Staff inspires a supportive and dedicated team environment and is committed to achieving excellence in outstanding patient care.”
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Communication
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Well Organized Theatre
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• 5S• Tidy OR• Slang Binder
Before & After
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Before After
Before & After
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Before After
Safety Cross & Pareto Chart
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Equipment
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Slang Binder
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Teamwork
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• Create a calmer working environment
• Reduce hierarchies and give everyone an equal voice
• Perform the Surgical Safety Checklist
• Review the slate and identify any glitches that can be remove
Grand Kick-Off
• Tremendous interdisciplinary turnout• Establish action plan
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Operational Status at a Glance
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• ORs ready to go
• All equipment is available & working
• Right staff in the right place
• Slate starts on time
• No cancellations, no delays
• Finish on time
First Case StartsJanuary 2015 Baseline
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Mapping Out the Patient’s Journey
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Culture Eats Strategy for Lunch
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Moving Forward
Increase teamwork and communication Empower the perioperative teamImprove efficiency of the OR (e.g. first case start times)Reduce waste by optimizing workflow and productivityImprove patient experience and outcome
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