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Managing urgent surgery as a process: Case study of a trauma center

Published online by Cambridge University Press:  28 March 2006

Paulus Mikael Torkki ,
Antti Ilmari Alho ,
Antti Veikko Peltokorpi ,
Markus Ilmari Torkki  and
Pentti Ensio Kallio
Paulus Mikael Torkki
Affiliation:
Helsinki University of Technology
Antti Ilmari Alho
Affiliation:
Helsinki University of Technology
Antti Veikko Peltokorpi
Affiliation:
Helsinki University of Technology
Markus Ilmari Torkki
Affiliation:
Helsinki University Central Hospital
Pentti Ensio Kallio
Affiliation:
Helsinki University Central Hospital
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Abstract

Objectives: Industrial management principles could be used to improve the quality and efficiency of health care. In this study, we have evaluated the effects of a process management approach to trauma patient care. The major objective was to reduce the waiting times and increase the efficiency of the hospital.

Methods: Urgent surgery care was analyzed as an overall process. The process development followed the Plan-Do-Check-Act (PDCA) cycle and was based on statistical analysis of certain performance metrics. Data were collected from hospital databases and by personnel interviews. To develop the process, the anesthesia induction was performed outside the operating room, better process guidance was developed, and patient flow was reorganized. The transition time for these changes was 1 year (2002 to 2003).

Results: Waiting times decreased by 20.5 percent (p<.05), nonoperative times in the operating room were reduced by 23.1 percent (p<.001), and efficiency was increased by 9.7 percent (p<.001) after reengineering of the care process. Overtime hours decreased by 30.9 percent.

Conclusions: Managing urgent surgical care as a process can improve the productivity and quality of care without a need to increase personnel resources. The focus should be on reducing waiting times and waste times.

Keywords

Process assessmentProcess metricsEfficiencyOperating room managementUrgent surgery
Type
RESEARCH REPORTS
Information
International Journal of Technology Assessment in Health Care , Volume 22 , Issue 2 , April 2006 , pp. 255 - 260
Copyright
© 2006 Cambridge University Press

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