RESUMO
Service block time allocation is a critical requirement for the optimization of patient throughput and access to care in the Surgical Services Service Line of the US Army Medical Command. The procedure complexity, volume, and diversity across 25 facilities create significant variation in service block time. This variation requires the involvement of both the informatics and leadership teams for block time allocation to be effective. This article describes our use of the Army's Surgery Scheduling System, which includes service block time as an embedded function, to develop a standardized process that helps ensure service block time is optimized. We also present guidelines for block time allocation and offer case studies that demonstrate the application of these guidelines.
Assuntos
Hospitais Militares/organização & administração , Salas Cirúrgicas/organização & administração , Duração da Cirurgia , Procedimentos Cirúrgicos Operatórios , Hospitais Militares/economia , Hospitais Militares/estatística & dados numéricos , Hospitais de Ensino/economia , Hospitais de Ensino/organização & administração , Hospitais de Ensino/estatística & dados numéricos , Humanos , Liderança , Salas Cirúrgicas/economia , Salas Cirúrgicas/estatística & dados numéricos , Admissão e Escalonamento de Pessoal , Procedimentos Cirúrgicos Operatórios/estatística & dados numéricosRESUMO
Measuring surgical business performance for Army military treatment facilities is currently done through 6 business metrics developed by the Army Medical Command (MEDCOM) Surgical Services Service Line (3SL). Development of a composite score for business performance has the potential to simplify and synthesize measurement, improving focus for strategic goal setting and implementation. However, several considerations, ranging from data availability to submetric selection, must be addressed to ensure the score is accurate and representative. This article presents the methodology used in the composite score's creation and presents a metric based on return on investment and a measure of cases recaptured from private networks.
Assuntos
Comércio/normas , Organização e Administração/normas , Projetos de Pesquisa , Comércio/estatística & dados numéricos , Eficiência Organizacional/normas , Eficiência Organizacional/estatística & dados numéricos , Administração Financeira/normas , Administração Financeira/estatística & dados numéricos , Humanos , Medicina Militar/economia , Medicina Militar/estatística & dados numéricos , Organização e Administração/estatística & dados numéricos , Carga de Trabalho/normas , Carga de Trabalho/estatística & dados numéricosRESUMO
The idea of the preoperative anesthesia clinic as a means of examining and treating the patient so that he will arrive in the operating theater as strong and healthy as possible is well established in practice and literature.However, problems in clinic design and execution often result in high patient waiting times, decreased patient and staff satisfaction, decreased patient capacity, and high clinic costs. Although the details of clinic design, outcomes, and satisfaction have been extensively evaluated at civilian hospitals, we have not found corresponding literature addressing these issues specifically within military preoperative evaluation clinics. We find that changing to an appointment-based (versus walk-in) system and eliminating data collection step redundancies will likely result in lower wait times, higher satisfaction, lower per patient costs, and a more streamlined and resource-efficient structure.