On our Way to TPOT

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On our way to The Productive Operating Theatre

Vancouver Coastal Health Authority

Felicia Laing – Quality and Patient SafetyAndra Grigore – RN Perioperative Services, LGH

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Key Areas of Focus

• What is The Productive Operating Theatre?• Knowing How We Are Doing• Well Organized Theatre • Team-Working• Operational Status At A Glance

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The Productive Operating Theatre

• A modular improvement program developed by NHS UK

• A structured way of approaching challenges and opportunities specific to our OR team

• Tools to improve communication between front line staff and senior leadership

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Productive Series Sites

TPOT Modules

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TPOT AIM

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Lions Gate Hospital

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Before TPOTNo common goal or visionPoor communicationDisorganized Operating RoomsMinimal team-buildingLimited quality improvement

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Knowing How We Are Doing

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• Set objectives• Measure how we

are doing across the 4 domains of quality

• PDSA and sustain

Visioning Workshop

• Staff discussed barriers to perfect work day

• Nurses, Surgeons, Anaesthetists, Periop Aides, Anaesthetic Assistant

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Themes and Dot-Voting

• Themes similar across ORs

• Essential for high functioning & reliable ORs

• Physicians voted for efficiency themes

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Vision Statement

“The LGH Perioperative Staff inspires a supportive and dedicated team environment and is committed to achieving excellence in outstanding patient care.”

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Communication

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Well Organized Theatre

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• 5S• Tidy OR• Slang Binder

Before & After

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Before After

Before & After

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Before After

Safety Cross & Pareto Chart

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Equipment

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Slang Binder

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Teamwork

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• Create a calmer working environment

• Reduce hierarchies and give everyone an equal voice

• Perform the Surgical Safety Checklist

• Review the slate and identify any glitches that can be remove

Grand Kick-Off

• Tremendous interdisciplinary turnout• Establish action plan

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Operational Status at a Glance

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• ORs ready to go

• All equipment is available & working

• Right staff in the right place

• Slate starts on time

• No cancellations, no delays

• Finish on time

First Case StartsJanuary 2015 Baseline

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Mapping Out the Patient’s Journey

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Culture Eats Strategy for Lunch

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Moving Forward

Increase teamwork and communication Empower the perioperative teamImprove efficiency of the OR (e.g. first case start times)Reduce waste by optimizing workflow and productivityImprove patient experience and outcome

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Thank You

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[email protected]

[email protected]