1. Cohesive Approach to Surgery PSAC ǀ Ministry of Health ǀ BCMA ǀ Health Authorities ǀ BCPSQC November 16, 2012

2. Survey Results A Cohesive Approach to Surgery November 2012

3. Number of respondents, by job title

5. # 1 Challenge Resources and Training Increase elective OR time More staff Training of staff/skilled staff Culture, Communication, Collaboration Acknowledgment of the problem and an openness to work on improving communication Senior management needs to create a safe environment for health care providers to communicate their differences respectfully. Improvement Opportunities Having the entire OR team working towards one cause; getting through the OR day as efficiently as possible without putting personal or union agendas first Terminology, consistency, and thorough documentation

6. Three Future Focus Areas OR Efficiency General support and interest Key to engage front line clinicians Sustainability a concern Leadership Development Mixed support for this direction Worried about more bureaucracy Some positive comments OR Team Training Positive Support Will at the front line Physicians might not be interested

7. Overarching Themes in Response to Future Areas 1.Front-line staff and clinical perspective is essential. It has to be bottom-up. 2.It must be done with a team approach, with participation and input from all team members. 3.Both physicians and others feel that physicians must be more engaged. 4.There is a tension between improving efficiency and providing additional resources. Are we asked to be more efficient when what we really need is more resources, or are we asking for more resources when what we should really focus on is efficiency? 5.Leadership, resources and clear communication is required. 6.It cannot be applied in a cookie-cutter manner. Improvement has to fit with local context.

8. Front-line driven solutions

9. IF YOU WERE A PATIENT What is the one thing that you would do to improve Perioperative Efficiency? 15 minutes to discuss Write it on the recipe card 1 minute report out from all tables

10. What’s next? How can we continue this dialogue?