Author of

• 12008

  +

  P2.25 - Poster Session 2 - Nurses (ID 249)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Nurses
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12009

    +

    P2.25-001 - Workflow improvement and results of standardization of thoracic surgery procedures among six hospitals (ID 1133)

    09:30 - 09:30  |  Author(s): K. Terauchi
    • Abstract

    Background
    Five full-time doctors are sent to 5 affiliated hospitals from University Hospital of Kyoto Prefectural University of Medicine. To conduct a surgery in the affiliated hospitals, a doctor is sent from the university, for ensuring an efficient and secure medical care with limited members. Until now, each hospital performed surgeries in its own way. However, to perform safer and efficient surgery with a limited number of operating room nurses and thoracic surgeons, they need to work as one team. We report the standardization of thoracic surgery procedures.

    Methods
    First, to understand the current situation at each affiliated hospital, we survey all aspects of surgical procedures. Subsequently, we held 5 meetings among the group and standardized the surgical procedures. A thoracic surgeon and 3–4 operating room nurses from each hospital joined in the discussion. The topics of the discussion covered all aspects of surgery and methods from each hospital were analyzed and standardized. We have already standardized the thoracoscopy system and energy device in all hospitals. We also standardized the main surgical instruments and methods in these meetings. The content of the standardized main surgical procedure was thoroughly explained in a video distributed to each hospital in DVD format. We evaluated the frequency of use of the surgical instruments and excluded rarely used items. To increase the understanding on automatic suture instruments and energy device, the important usage points were shared in the meeting. Nurses were trained on the usage. In the 6[th] affiliated hospital meeting, a questionnaire was conducted to survey the awareness of this approach.

    Results
    The amount of time required from entering the operating room to starting the surgery was shortened from 62 to 55.5 minutes (average). The time required from the end of surgery to exiting the operating room was also shortened from 46.1 to 38.7 minutes (average). The difference among hospitals was successfully reduced. Because the main surgical instruments and methods were standardized, almost the same level of surgery could be performed in each hospital. Surgical instruments were reduced from 48.3 to 41.1 types (average). Total number of surgical instruments was successfully reduced from 91.8 to 73.5 items (average). In the questionnaire, all members referred to other hospitals devices, and they will attempt productions of their own device. All members confirmed improved understanding on thoracic surgery and 88% confirmed increased interest in thoracic surgery．

    Conclusion
    Standardization of the surgical procedures improved the workflow, enabled safe and efficient surgery among the affiliated hospitals, and increased awareness of the importance of workflow improvement. Change in awareness toward thoracic surgery was observed among participating members, suggesting that the present approach is highly useful.