Improving Efficiencies in an OB/OR by Forming Inter-Professional Team Relationships Waters J.H., Chief, Dept. of Anesthesiology; Karen Daily RNC,MSN; Linda.

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Improving Efficiencies in an OB/OR by Forming Inter-Professional Team Relationships Waters J.H., Chief, Dept. of Anesthesiology; Karen Daily RNC,MSN; Linda Dudas RNC, MSN,CNL Assessment. Background Preparation and Planning Description of Team Baseline Data 7:30AM and Overall On-Time Scheduled Cases March May 2014 Statement of Successful Practice Data Results Initiative began June 26,2014 7:30AM and Overall On-Time Scheduled Cases May 2014-Jan 2015 Operating room team performance is an important component in providing safe and effective care for surgical patients. Research indicates that surgical teams are not as cohesive as could be expected and that communication failures frequently occur. Organizing work to promote inter-professional interaction can foster the social relations that support the common goal of patient safety. Individuals are connected most closely within their own professional groups; however, intergroup communication for the purposes of solving work- related problems potentially contributes to quality patient care. A multidisciplinary approach was taken to create an environment where the surgical obstetric patient can receive cohesive inter-professional care in a large, university hospital birth center. The literature shows that improvement in communication is a means for improving patient safety. A multidisciplinary team consisting of obstetric, surgical, and newborn nurses; leadership; surgical technicians; obstetric surgeons; physician’s assistant; anesthesia; environmental services; and the scheduling secretary was established to improve communication and working relationships. The need for nursing representation from Triage, the Labor Suite, and the OB/ICU was identified. The initiative assessed the patient experience with the goal of increasing on-time scheduled cases and increasing patient satisfaction. A proposal was developed using an inter- professional team of obstetric, anesthesia, and surgical specialists to care for the obstetric surgical patient. Implementation A change in culture was needed for this group to work as a collaborative team to improve patient safety and satisfaction as well as OR efficiencies. Implementation Quality Initiatives Included; 1.A core OR/Pre/Post nursing team was created. 2.Daily “Huddle” of all team stakeholders is held at 6:45AM to discuss the day’s scheduled cases, and identify potential surgical cases from the unit. 3.Surgeons have been directed to attend 4.the huddle if they have the 7:30AM case. 5.Circulating nurse and surgical technician assist in room turnover. Since the initiation of the quality initiatives service recovery has decreased from 54 to 12 per month as reported by patient relations. Room turnover time has decreased from 45 minutes to 14 minutes. Obstetrical Surgical Services on-time rate for first case of the day has increased from 8% to 91% and the on-time rate for all cases has increased from 28% to 66%. The implementation of this project continues to guide the inter-professional team to focus as a collaborative group on OR efficiencies and patient satisfaction. The reward of improved OR on-time statistics and increased patient satisfaction has encouraged the team to continue to strive for improvement.