Abstract
Purpose
This performance improvement project was undertaken to reduce costly delays in first-case,
operating room (OR) start times.
Design
Two Plan, Do, Study, Act (PDSA) cycles.
Methods
In PDSA 1, student nurses observed 30 patients' paths of travel from hospital entrance
to OR and documented time spent at key stopping points. Directional signs were placed
after PDSA 1. PDSA 2 consisted of an electronic medical record (EMR) review of pre-
and postsignage cases (n = 492 and n = 538 respectively).
Findings
In the initial PDSA cycle (n = 30), one reason for delay was the time patients spent
finding the preoperative area (POA). Signage was placed at strategic points noted
to confuse patients. PDSA cycle 2 found median presignage POA arrival times (34 minutes)
were significantly higher than postsignage POA arrival times (20 minutes) (U = 51,618.0,
z = −16.934, P < .001).
Conclusions
Delayed wayfinding contributed to delayed OR starts but improved with appropriate
signage.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic and PersonalCorporate R&D ProfessionalsOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of PeriAnesthesia NursingAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- First-case operating room delays: patterns across urban hospitals of a single health care system.J Patient-Centered Res Rev. 2016; 3: 125-135
- Improving first case start times using Lean in an academic medical center.Am J Surg. 2017; 213: 991-995
- The true relevance of first-case start delays.Am J Surg. 2015; 209: 427-429
- A comprehensive approach to facilitate wayfinding in healthcare facilities.in: Design4Health: Proceedings of the 3rd European Conference on Design4Health. July 13-16, 2015 (Sheffield, UK)
- Hospital as city: employing urban design strategies for effective wayfinding.Health Facil Manag. 2007; 20: 61
- Hospital wayfinding: Whose job is it?.2011 (Available at:)
- Design That Cares: Planning Health Facilities for Patients and Visitors. Vol. 142. John Wiley & Sons, Hoboken, NJ2016
Article Info
Publication History
Published online: September 24, 2019
Footnotes
Conflict of interest: None to report.
Identification
Copyright
© 2019 American Society of PeriAnesthesia Nurses. Published by Elsevier, Inc. All rights reserved.
