A Case Study Perspective for Balanced Perioperative Workflow Achievement through Data-Driven Process Improvement

Abstract

Based on a 143-month longitudinal study of an academic medical center, this paper examines operations management practices of continuous improvement, workflow balancing, benchmarking, and process reengineering within a hospital's perioperative operations. Specifically, this paper highlights data-driven efforts within perioperative sub-processes to balance overall patient workflow by eliminating bottlenecks, delays, and inefficiencies. This paper illustrates how dynamic technological activities of analysis, evaluation, and synthesis applied to internal and external organizational data can highlight complex relationships within integrated processes to identify process limitations and potential process capabilities, ultimately yielding balanced patient workflow through data-driven perioperative process improvement. Study implications and/or limitations are also included.

A Case Study Perspective to the Digital Transformation of a Hospital’s Perioperative Process

“…UHPS focuses BPM on data-driven analysis of KPIs at strategic, tactical, and operational levels via balanced scorecards and dashboards, aligned to hospital strategy [36,38]. To this end, numerous BPM efforts have targeted multiple perioperative sub-processes to improve patient workflow [37]. Table 2 details a complete listing and timeline of BPM efforts as perioperative improvements by sub-process.…”

“…Intravenous medications (e.g., CPoE, Pharmacy IS, and medication distribution devices via Figure-2) are available as ordered or needed. The CSS prepared case cart (e.g., up to 8-hours in advance) contains supplies and instruments for the patient's specific surgical procedure per the CSIS SPC pick list (e.g., Table 1) [37].…”

Improving Perioperative Data Integrity and Quality via Electronic Medical Record Reconciliation

“…Using this systematic BPM approach, UHPS implemented numerous improvement efforts across each of the perioperative sub-processes (e.g., pre-assessment, PreOP, OR, PACU, and CSS) to improve and balance patient workflow [33].…”

“…The IHIS depicted in Figure-1 depicts how the integrated CSIS schedules, records, and facilitates perioperative workflow across UHHS, where the CSIS coordinates, facilitates, and documents perioperative patient care and outcomes [33]. Integration of the IS depicted in Figure-1 occur with either bidirectional data exchange or unidirectional for limited exchange.…”

“…UHPS nurses record patient care details into the CSIS as EMRs to manage and document patient care across perioperative workflow. Table-2 is the current UHHS listing of CSIS nursing documentation EMRs that includes the fiscal implementation year of UOS charge capture, UOS standard, UOS unit, and associated perioperative sub-process [33].…”