Prepared by Christine LassenMay 2012

First Case on Time

Australian Government 2011 Airline On Time Performance

http://www.bitre.gov.au/statistics/aviation/otp_annual.aspx

Ladies and gentlemen we regret to inform you .....

One in five flights in Australia is delayed by more than fifteen minutes

The number of cancellations in 2011 reaching 1.8 per cent, double the figure of the year before

Simply put, every third return trip you make by plane will be delayed in some way.

http://www.dailytelegraph.com.au/travel/travel-advice/handy-tips-on-how-to-survive-flight-delays/story-e6frezor-1226285112522

Being late

“I have noticed that the people who are late are often so much jollier than the people who have to wait for them.”

E.V Lucas (1868-1938)

Learning Outcomes

KPIs for OT efficiency should not be used as outcome measures in isolation

Understand how KPIs can be used as leverage tools to increase efficiency

Achieving compliance with ‘95% first case on time theatre starts’ is not just about the day of operation but also includes planning from the patient’s initial booking for surgery

FCoT Definitions

Anaesthetic start time

Wheel into theatre time

Knife to skin

When the scout nurse hits the right SurgiNet button

When we all do ‘time-out’

When the patient is prepped

When the patient is draped

?????

Surgery Dashboard Indicators 2011/12

http://www.archi.net.au/documents/resources/hsd/surgery/predictable_surgery/surgery-dashboard.pdf

The Dashboard

Reporting FCoT KPI

Monthly KPI

Reported on Surgical Dashboard for last 2 years

Reported by LHD

Reported and discussed at SST

Currently NSW average = 40 – 50%

Target = 95%

Assess

• Develop & distribute survey• Survey analysis

Design & Construct

Operate & Review

MoH Project Plan

68 responses - both metropolitan and non-metropolitan

Opened 07/02/12; closed 13/03/12

Anaesthetic Bays Y 80%

Same time starts surgeons & anaesthetists Y 85%

Staggered start times for elective lists N 75%

% First Case on Time Theatre Starts KPISurvey Results

% First Case on Time Theatre Starts KPISurvey Results

OT Management Committee Y 83%

Who belongs?

Nurses, Surgeons, Anaesthetists, Business Managers, DCS/DMS, CSSD Managers, Exec/GM, DON/ADON, Bookings Managers, Data Managers

OT Management Committee drives the KPI?

% First Case on Time Theatre Starts KPISurvey Results - Comments

“We always have our patients here ready to go for the start of a list. The Anaesthetist and Surgeons are continually late. I have been reporting this on a monthly basis for 8 years. I hope the problem can be fixed.”

“This is a multifaceted problem that will require a concentrated project and additional costs if the expectation is that the start time is surgical access only………..This is now on our agenda to review and discuss with hospital executive.”

“Medical staff generally do not want to know, as they feel their excuses are justified. Nursing staff are forced to try and police this.”

SurgiNet Reporting 

 

SurgiNet Reporting

Assess

• Develop & distribute survey • Survey analysis• Develop & distribute checklist• Site visits (6 metro) – process & patient flow

Design & Construct

Operate & Review

MoH Project Plan

The Whole Efficiency Process

The Checklist

The Dashboard

Assess

• Develop & distribute survey • Survey analysis• Develop checklist• Site visits (6 metro)• Data presentation SST

Design & Construct

Operate & Review

MoH Project Plan

“...rounding up cats...”

http://www.youtube.com/watch?v=Pk7yqlTMvp8

References

http://www.archi.net.au/documents/resources/hsd/surgery/predictable_surgery/surgery-dashboard.pdf