“Peri-Operations” Process Reengineering

Hospitals across the country are undertaking major projects including renewal, redevelopment, modernization, extension, and even new towers that will impact daily operations. Operational excellence is essential for hospital revenue, as surgical services are the backbone of hospital revenue.

It’s not usually top of mind to prioritize workflow and organization. However, improving space utilization can add up to dollars on the bottom line through increased room utilization, turnover, and the ability to adapt to changing procedures and services. It is essential to communicate what works in order to ensure safe and efficient patient care and employee satisfaction because the cost is significant and the space is likely to last decades.

People who work in the healthcare industry often refer to space dedicated to direct patient care as prime real estate. In this premium area, surgery suites and other revenue-generating areas are prioritized. Procedural areas usually don’t have enough storage capacity and the need for adequate storage for day-to-day essentials should be equally important, but storage is frequently ill-designed for typical workflows.

The benefits of standardizing and optimizing are worth the effort even if getting everyone on board can be challenging.

A storage project is a perfect way to engage staff when preparing for a construction project that will impact where things live, whether it be surgery supplies, instruments or equipment storage. With the LEAN process, each workflow and storage area can easily be broken down into stages resulting in quicker case preparation and immediate positive feedback.

Future state storage solutions should include a central location where sterile supplies, instruments and implants can be quickly accessed by every operating room.   The department workflow and organization should be evaluated to consider specific supply performance goals.

Standardize Case Cart Prep & Set-Up
Reduce case prep “hunting and gathering” specialty supplies & implants
Increase efficiencies; throughput / turnaround time.
Promote staff satisfaction and preparedness.
  •  Prioritize accessibility – can be shared in core space depending on volume & replenishment processes
    1. Sterile Core
      • General supplies, specialty supplies implants, and equipment storage .
      • Shared items should be convenient to each point of use
      • Linens, Fluids, Positioning Devices
      • Blanket & Fluid Warmer Cabinets
      • Automated Medication Dispensing Cabinet (Pyxis / Omnicel)
    2. Perimeter, Closets, Nooks, Storage Rooms
  • Standardize where possible
    1. Main Warehouse / Core – General Supplies (consumable/single use items)
    2. Direct Purchase – Specialty Items & Implants
    3. Consignment – Specialty Supplies & Implants
    4. Equipment / Carts
  • Consolidate service-specific items
    1. Supplies & implants to reduce inventory and par levels to support volume within anticipated replenishment timeframes. 
    2. Equipment closer to primary point of use to save time between turnovers
  • Space Utilization / Orientation / Standardization
    1. Operating Rooms/Suites
    2. Procedure Rooms
    3. Sterile Core 
    4. Clean Supplies, Linens, Fluids
    5. Hallways (scrub sink areas, alcoves)
    6. Cleaning / Turnovers
  • Process
    • Case Prep
      • Instruments
      • General Supplies / Soft Goods
      • Suture
      • Positioning Devices
      • Equipment
    • Implants / Specialty Items
    • Consignment
    • Tissue
    • Workflows
      • Room Utilization – Fast Cases (Pre/Post/Same-Day) Trauma / Emergent, Add-on
      • Put-away
      • Replenishment
      • Room Turnover
      • Room Reset

Systems Analysis and Process Improvement:

  • Equipment, Specialty Supplies & Implants Storage Planning:  Initiate space and storage utilization study to evaluate flow and storage of equiment and supplies in the perioperative environment. The detail design phase of a project provides the best opportunity to evaluate use of space, workflow standardization, time efficiency, and process improvement. Departmental core services currently operating independently will gain efficiencies by optimizing like processes and consolidating resources including staff and space.

    We use a tiered system for line item analysis.  The analysis tool we develop provides data and rationale for space utilization and identifies potential gaps by location and proximity.  Our team will provide support to define strategic, operational, functional and space planning for Equipment, Supplies and Implants.

    • Provide assessment of equipment and supplies to determine use of space, workflow impact and gap in space vs equipment/supply needs
    • Develop data-driven recommendations for IV platform equipment and supply storage
    • Develop recommendations for centralized storage of point of care supplies, supply carts, and implants
    • Identify opportunities for common area spaces shared between patient care areas to promote quick access

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