Improvement project about canceling surgery patients

docx

School

Harvard University *

*We aren’t endorsed by this school

Course

9209

Subject

Nursing

Date

Nov 24, 2024

Type

docx

Pages

Uploaded by Jmtk4924

1 Improvement project about canceling surgery patients Student’s Name Institution Course Date

2 Introduction The Maternity and Children's Hospital in Mecca, with a dedicated Operations Department, stands as a vital institution in the provision of healthcare services. This department, comprising 41 nurses operating on an average of 3 shifts, plays a pivotal role in ensuring the well-being of both mothers and children. With 9 specialized rooms, the hospital demonstrates a commitment to providing quality care in a conducive environment. The leadership structure of the department is composed of a Head Nurse and two Team Leaders, overseeing and coordinating the efforts of the nursing staff. As we delve into the intricacies of the department's operations, it becomes evident that a detailed analysis is necessary to optimize the scheduling of surgeries and mitigate the challenges associated with cancellations. The following exploration will employ clinical judgment, decision-making processes, and critical thinking to address the unique aspects of surgery scheduling within the Maternity and Children's Hospital in Mecca. Scenario Objectives In embarking on the simulated case scenario concerning surgery cancellations at the Maternity and Children's Hospital in Mecca, the primary objective is to tackle the multifaceted challenges associated with the scheduling of surgeries. At the heart of this endeavor is the overarching goal to elevate the standard of patient care, optimize the utilization of hospital resources, and mitigate the disruptive impact of cancellations on both patients and the operational workflow of the hospital. The first key objective of the simulation is a meticulous identification of the root causes contributing to surgery cancellations within the Operations Department. This involves an in- depth analysis of the existing scheduling processes, potential bottlenecks, and external factors that may be influencing cancellations ( Al-Nafea, Alshargi, & Algethami, 2022 ). By

3 systematically defining these causes, the simulation aims to provide a comprehensive understanding of the issues at hand, laying the groundwork for targeted interventions and process improvements. The second pivotal objective is the prioritization of the identified causes based on their significance and impact on the surgical scheduling process. Through the application of clinical judgment and critical thinking, the simulation seeks to discern the most common and critical reasons leading to surgery cancellations. This prioritization process is crucial for effective resource allocation and the development of corrective action plans, ensuring that interventions are directed towards the most impactful factors. Furthermore, the scenario aims to leverage various decision tools and techniques to conduct a thorough analysis and interpretation of the contingency. Utilizing tools such as fishbone diagrams and Pareto analysis, the simulation will visually represent and quantify the relationships between different variables, aiding in the identification of the vital few causes that significantly contribute to the issue ( Alsulamy, 2021 ). These decision tools serve as a strategic compass for devising effective solutions and preventive measures. The simulation also entails a comprehensive review of existing literature and theoretical information related to surgery scheduling and cancellations. This comparative analysis involves scrutinizing the actual findings within the Maternity and Children's Hospital in Mecca against the theoretical knowledge available in the literature. By conducting this comparison, the project aims to identify potential gaps in current practices and explore how these gaps can be managed or filled through corrective actions or strategic plans. The scenario objectives encompass a holistic and systematic approach to understanding, analyzing, and addressing surgery cancellations within the Operations Department. Through a combination of targeted identification,

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version

Access to all documents
Unlimited textbook solutions
24/7 expert homework help

4 prioritization, decision tool application, and theoretical exploration, the simulation aims to enhance the overall efficiency and effectiveness of the surgical scheduling process at the Maternity and Children's Hospital in Mecca. Analysis of the Scenario (Situation) In delving into the current situation surrounding surgery cancellations at the Maternity and Children's Hospital in Mecca, it is imperative to paint a comprehensive picture of the challenges faced within the Operations Department. The hospital, despite its critical role in maternal and pediatric care, grapples with a notable issue: the occurrence of surgery cancellations. At present, surgery cancellations within the Operations Department are a persistent concern that demands urgent attention. The hospital, with its 41 nurses operating on an average of 3 shifts, is designed to accommodate a significant caseload. However, the existing scheduling processes have resulted in a discernible number of cancellations, impacting both the efficiency of operations and, more critically, patient care. Symptoms of this issue manifest in various ways. Patients experience inconvenience and uncertainty due to cancellations, leading to heightened stress levels. The nursing staff, comprising dedicated professionals, is burdened with the task of managing cancellations, often resulting in increased workloads and potential burnout. Furthermore, the hospital's operational workflow is disrupted, affecting the overall delivery of care. Identification of the symptoms naturally leads to the exploration of underlying causes contributing to the problem. Preliminary analysis suggests that a lack of coordination in the scheduling process, possibly stemming from communication gaps between the nursing staff and administrative personnel, plays a pivotal role. Additionally, external factors such as unforeseen

5 emergencies and inadequate resources may be contributing to the cancellations ( Nasrulddin, 2020 ). Further probing reveals potential discrepancies in the allocation of resources, both human and infrastructural, leading to inefficiencies in the scheduling process. The 9 specialized rooms available may not be optimally utilized, and the leadership structure, though present with a Head Nurse and two Team Leaders, may need to be further engaged in mitigating cancellations. In essence, the current scenario is characterized by a substantial number of surgery cancellations, adversely affecting patients, nursing staff, and the hospital's operational efficiency. Understanding the symptoms and the preliminary identification of causes provides the foundation for a more in-depth analysis, utilizing decision tools and theoretical frameworks to drive effective solutions and improvements within the Operations Department. Dimension of the Scenario Symptoms Observable issues and challenges related to surgery cancellations manifest in several notable symptoms within the Maternity and Children's Hospital in Mecca's Operations Department. Patient dissatisfaction is a prevalent symptom, with individuals experiencing heightened stress and inconvenience due to the unpredictability of cancellations. This emotional strain not only affects the immediate well-being of the patients but also has potential long-term implications for their overall healthcare experience. The nursing staff, dedicated as they are, face increased workloads and potential burnout as they navigate the complexities of managing cancellations ( Alsaggaf, & Coyne, 2023 ). Moreover, the hospital's operational workflow experiences disruptions, impacting the timely and efficient delivery of care to both mothers and children.

6 Causes A comprehensive exploration of both internal and external factors sheds light on the root causes contributing to surgery cancellations. Internally, a lack of effective coordination and communication in the scheduling process stands out as a significant contributor. This coordination gap may result from inadequate information exchange between nursing staff and administrative personnel, leading to suboptimal planning. External factors, such as unforeseen emergencies or inadequate resources, play a role in the cancellations, indicating a need for a more robust contingency plan. Furthermore, resource allocation discrepancies, both human and infrastructural, contribute to inefficiencies in the scheduling process. The 9 specialized rooms may not be optimally utilized, and the leadership structure, while present, may need further engagement to address these internal challenges comprehensively. Stakeholders Identifying key participants involved in the scenario is crucial for devising targeted interventions. Within the department, the nursing staff of 41, working across an average of 3 shifts, plays a pivotal role in the execution of the scheduling process and bears the direct impact of cancellations. The leadership structure, comprising 1 Head Nurse and 2 Team Leaders, is instrumental in overseeing the department's operations. Externally, patients and their families are key stakeholders, directly affected by cancellations. Collaborative efforts with administrative staff, hospital management, and emergency response teams are vital to addressing both internal and external factors contributing to surgery cancellations ( Al Talalwah, McIltrot, & Al Ghamdi, 2019 ). Recognizing and engaging with these stakeholders will be integral to the success of any proposed solutions and improvements within the Operations Department. Decision Tool (Fishbone Diagram)

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version

Access to all documents
Unlimited textbook solutions
24/7 expert homework help

7 In our quest to comprehensively understand the cause-and-effect relationships contributing to surgery cancellations at the Maternity and Children's Hospital in Mecca, we employ a highly effective decision tool known as the fishbone diagram. This visual representation, also known as an Ishikawa or cause-and-effect diagram, facilitates a systematic exploration of potential factors and their interconnections, allowing for a nuanced analysis grounded in clinical judgment, decision-making, and critical thinking processes. Process People Equipment Environment Policies 1. Headings and Primary Causes At the head of the fishbone diagram, we identify the primary categories or headings representing potential causes. These categories, derived from the initial analysis, may include Process, People, Equipment, Environment, and Policies. Each of these broad categories serves as an umbrella under which specific causes contributing to cancellations can be explored. 2. Secondary Causes Surgery Cancellations Lack of Clear Guidelines for Handling Emergencies Suboptim al Room Utilizatio n Resource Allocation Staff Training Issues Inadequate Coordination and Communication

8 Beneath each primary category, we delve into secondary causes specific to the Operations Department at the Maternity and Children's Hospital in Mecca. For example, under the Process category, inadequate coordination and communication in the scheduling process may be identified. Similarly, within the People category, issues related to staff training or workload management may be explored. This detailed breakdown allows for a granular examination of potential root causes. 3. Cause-and-Effect Relationships As we connect the secondary causes to their respective primary categories, the fishbone diagram visually illustrates the cause-and-effect relationships. This process requires a careful consideration of how each identified cause influences or interacts with others. For instance, insufficient communication between nursing staff and administrative personnel may contribute to coordination issues, affecting the overall scheduling process. 4. Involvement of Stakeholders Throughout the creation of the fishbone diagram, stakeholders such as nursing staff, administrative personnel, and leadership are actively engaged in the analysis. Their insights, gathered through collaborative sessions or surveys, contribute valuable perspectives on the potential causes and their relationships. This involvement ensures a holistic and accurate representation of the factors leading to surgery cancellations. 5. Iterative Refinement

9 The fishbone diagram serves as a dynamic tool, allowing for iterative refinement as new insights emerge. Clinical judgment, decision-making, and critical thinking processes are continuously applied to assess the completeness and accuracy of the diagram. Stakeholder feedback, data analysis, and further exploration may prompt adjustments to the diagram, ensuring its alignment with the evolving understanding of the scenario. In utilizing the fishbone diagram, we aim to create a visual roadmap that not only identifies the causes contributing to surgery cancellations but also facilitates the development of targeted solutions. This decision tool stands as a cornerstone in our commitment to a thorough and informed analysis of the Operations Department's challenges at the Maternity and Children's Hospital in Mecca. Framework Process for Analyzing and Addressing Surgery Cancellations In the pursuit of resolving surgery cancellations at the Maternity and Children's Hospital in Mecca, a systematic framework unfolds: Scope Definition and Objectives In defining the scope, the focus is placed on specific surgeries or departments that are prominently contributing to cancellations. This may involve categorizing surgeries based on complexity, patient demographics, or other relevant factors. Objectives are formulated to align with overarching goals, emphasizing enhanced patient care, resource optimization, and operational efficiency. Data Collection and Analysis A meticulous approach to data collection involves gathering information on various aspects of surgery cancellations. Quantitative data includes the types of surgeries affected, frequency of cancellations, and historical trends. Qualitative data delves into the reasons behind

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version

Access to all documents
Unlimited textbook solutions
24/7 expert homework help

10 cancellations and the experiences of stakeholders. Rigorous analysis techniques are then applied to identify patterns, correlations, and outliers within the dataset. Stakeholder Engagement Stakeholder engagement is a collaborative effort involving key players such as nursing staff, administrative personnel, surgeons, and departmental leaders. Interviews, surveys, and focus groups are conducted to extract firsthand insights and perspectives. This inclusive approach fosters a shared understanding of the challenges and ensures that solutions are informed by the collective expertise of those directly involved ( Caesar et al., 2021 ). Fishbone Diagram Utilization The fishbone diagram, or Ishikawa diagram, serves as a visual representation of the cause-and-effect relationships contributing to surgery cancellations. Categories such as Process, People, Equipment, Environment, and Policies are identified, and specific causes are mapped under each. Stakeholders actively contribute to the creation of this diagram, utilizing their expertise to ensure a comprehensive and accurate representation of the factors at play. Root Cause Analysis Building on the insights from the fishbone diagram, a focused root cause analysis is conducted. Methodologies like the "5 Whys" are employed to systematically explore the underlying causes of cancellations. This phase aims to move beyond surface-level issues and identify the fundamental factors that, when addressed, will have a meaningful impact on reducing surgery cancellations. Causes Prioritization In the quest to address surgery cancellations at the Maternity and Children's Hospital in Mecca, a meticulous examination of potential causes unfolds, aiming to discern the most

11 common and impactful contributors. This prioritization process involves a comprehensive analysis, carefully weighing the significance of each cause in the context of cancellations ( Dyb, 2019 ). Identification of Most Common Causes Through an amalgamation of data, stakeholder engagements, and insights derived from the fishbone diagram and root cause analysis, a list of potential causes emerges. Causes that consistently surface across various datasets, stakeholder perspectives, and analytical methods are identified as the most prevalent contributors to surgery cancellations. Assessment of Impact Each cause undergoes scrutiny based on its impact on surgery cancellations. This involves a deep dive into data trends, stakeholder feedback, and the findings from the root cause analysis to gauge the magnitude of each factor's contribution to the cancellations. Prioritization Criteria Establishing criteria for prioritization becomes pivotal, encompassing both the frequency and impact of each cause. Priority is accorded to causes that not only manifest frequently but also exert a substantial influence on cancellations. Feasibility, potential for improvement, and alignment with the hospital's overarching objectives are integral components of the prioritization criteria. Stakeholder Involvement Active engagement of stakeholders, including nursing staff, administrative personnel, and leadership, becomes instrumental in the prioritization process. Their insights, experiences, and expertise provide a contextual richness that contributes to a nuanced understanding of each cause. Collaborative sessions and feedback mechanisms ensure that the prioritization reflects a

12 consensus among those intimately involved in scheduling and cancellations ( Sales-Coll, de Castro, & Hueto-Madrid, 2023 ). Final Prioritization The prioritization process culminates in the identification of a select number of causes deemed the most common and impactful. These causes emerge as focal points for intervention strategies and corrective actions. The final prioritization serves as a strategic guide for resource allocation, directing efforts toward the critical few causes that, when addressed, are anticipated to yield the most significant improvements in reducing surgery cancellations. Pareto Analysis for Surgery Cancellations In addressing surgery cancellations at the Maternity and Children's Hospital in Mecca, the Pareto Analysis proves instrumental. The initial step involves identifying the vital few causes, which have been consistently recognized as both common and impactful through a meticulous prioritization process. The selection of these causes lays the foundation for a focused and efficient analysis. Subsequently, a comprehensive compilation of data is undertaken, encompassing the frequency and impact of each vital cause. This involves integrating insights from stakeholder engagements, root cause analysis, and data trends identified in earlier phases. Quantitative analysis is then applied to assign numerical values to the frequency and impact of each vital cause. This data-driven approach ensures a nuanced understanding of the causes and their respective contributions. The creation of the Pareto chart follows, a meticulous arrangement of causes in descending order of their contribution, with the most impactful cause positioned on the left side. Each cause is visually represented by a bar, and the cumulative percentage is plotted, adhering to the 80/20 distribution. The strategic establishment of a threshold on the Pareto chart at the 80%

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version

Access to all documents
Unlimited textbook solutions
24/7 expert homework help

13 mark serves as a guide, signifying where the vital few causes cumulatively contribute to the majority of cancellations. This delineation becomes crucial for determining the focal points for strategic action. With the Pareto chart in place, strategic attention is directed towards the causes positioned on the left side, recognized as the vital few. These causes become the epicenter for targeted interventions and resource allocation, with efforts aimed at maximizing the impact on reducing surgery cancellations. Finally, the Pareto chart transforms into a dynamic monitoring tool. As interventions are implemented, the chart is consistently updated to reflect changes in the distribution of causes. This iterative process ensures that efforts remain aligned with the evolving landscape of surgery cancellations, allowing for real-time adjustments and refinements. Through the Pareto analysis, the hospital gains a profound understanding of the critical causes, enabling a focused and efficient approach to address surgery cancellations within the Operations Department. Alternatives To address the prioritized causes of surgery cancellations at the Maternity and Children's Hospital in Mecca, several alternative solutions are proposed, each carefully evaluated for feasibility and potential impact. One proposed solution involves the development and implementation of enhanced scheduling protocols. This approach aims to minimize conflicts and improve coordination among departments, potentially mitigating scheduling issues at the root. While it poses a moderate feasibility challenge due to the need for improved coordination and communication, the potential impact is high ( Johnson, Burgess, & Sethi, 2020). ). Another alternative is to focus on surgeon training and resource allocation. By providing additional training for surgeons on efficient time management and optimizing resource

14 allocation, delays can be reduced. This solution is highly feasible, with the potential for targeted training programs, and it carries a moderate to high potential impact by directly addressing issues within the surgical process. Implementing advanced communication systems is also considered. This alternative seeks to enhance real-time information flow among staff, reducing the likelihood of misunderstandings. While it has a moderate feasibility, requiring technology integration and staff training, the potential impact is high, improving overall communication efficiency ( Dowd et al., 2023 ). Furthermore, enhancing patient education regarding pre-surgery preparations is proposed. This alternative, characterized by high feasibility through the development of educational materials and staff training, could have a moderate impact by addressing issues related to patient readiness. Lastly, the establishment of a cross-departmental task force is suggested. This task force would work collaboratively to identify and address issues collectively. While it presents a moderate feasibility challenge, requiring organizational restructuring and stakeholder buy-in, the potential impact is high, promoting a holistic approach to problem-solving. In evaluating these alternatives, it becomes imperative to consider not only their potential impact on reducing surgery cancellations but also the practicality of implementation within the existing hospital infrastructure and resource constraints ( Dowd et al., 2023 ). The chosen alternatives should align with the hospital's goals and resources, setting the stage for detailed planning and implementation in the subsequent phase. Conclusion

15 In conclusion, the analysis of surgery cancellations at the Maternity and Children's Hospital in Mecca reveals key insights into the multifaceted challenges encompassing scheduling, communication, and resource management. The prioritization process, guided by the Pareto Principle, identifies vital causes, including scheduling protocols, communication inefficiencies, and patient readiness. Proposed action plans, such as enhanced scheduling, surgeon training, and communication system implementation, alongside patient education initiatives and a cross-departmental task force, offer tailored solutions. Moving forward, the hospital must embark on a phased implementation, considering feasibility and potential impact, with continuous monitoring to gauge effectiveness. This comprehensive action plan signifies a strategic roadmap toward reducing surgery cancellations, enhancing patient care, and improving operational efficiency within the Operations Department.

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version

Access to all documents
Unlimited textbook solutions
24/7 expert homework help

16 References Al Talalwah, N., McIltrot, K. H., & Al Ghamdi, A. (2019). Elective surgical cancellations in a tertiary hospital in the Middle East: quality improvement process. Journal of PeriAnesthesia Nursing , 34 (2), 310-321. Al-Nafea, A., Alshargi, O., & Algethami, M. (2022). Patients and family members perspectives on the use of bedside whiteboards and its implication to treatment outcomes and patient satisfaction: A pilot survey in general and tertiary hospitals in Makkah, Saudi Arabia. F1000Research , 11 , 150. Alsaggaf, F., & Coyne, I. (2023). Participation in everyday life for young people with chronic pain in Saudi Arabia: “you feel lacking in life and you feel that time is flying by”. Frontiers in Rehabilitation Sciences , 4 , 1099345. Alsulamy, N. (2021). Exploring the barriers and facilitators towards implementation of shared decision-making in primary healthcare centres in Saudi Arabia (Doctoral dissertation, University of Sheffield). Caesar, U., Karlsson, L., Hamrin Senorski, E., Karlsson, J., & Hansson‐Olofsson, E. (2021). Delayed and cancelled orthopaedic surgery; are there solutions to reduce the complex set of problems? A systematic literature reviews. International Journal of Clinical Practice , 75 (9), e14092. Dowd, S., Thompson, J. A., Pearson, J. A., Pinero, S., & Simmons, V. C. (2023). Education for Registered Nurses Completing Preoperative Anesthesia Interviews: A Quality Improvement Project. Journal of PeriAnesthesia Nursing , 38 (3), 382-393.

17 Dyb, K. (2019). Patient Reported Reasons for Surgery Cancellations Do Not Necessarily Correspond with Hospitals’ Representation of the Same Problem. In Health Informatics Vision: From Data via Information to Knowledge (pp. 75-78). IOS Press. Johnson, M., Burgess, N., & Sethi, S. (2020). Temporal pacing of outcomes for improving patient flow: Design science research in a National Health Service hospital. Journal of Operations Management , 66 (1-2), 35-53. Nasrulddin, V. M. (2020). Corporatisation and the performance of hospitals in the Kingdom of Saudi Arabia: A panel study, 1979-2014 (Doctoral dissertation). Sales-Coll, M., de Castro, R., & Hueto-Madrid, J. A. (2023). Improving operating room efficiency using lean management tools. Production Planning & Control , 34 (13), 1261- 1274.

Improvement project about canceling surgery patients

Related Documents