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BENCHMARKING EMERGENCY CASELOAD PERFORMANCE

Perioperative Services Management, Vancouver Hospital and Health Sciences Centre, CP3, Room 380, 855 W. 12th Ave. Vancouver, BC V5Z 1M9

INTRODUCTION

A four level unscheduled case priority-ranking system was instituted which serves as the queuing mechanism for unscheduled surgery. Priority 1 (to be started within 1 hr), Priority 1b (to be started within 4 hrs), Priority 2 (to be started within 8 hrs), Priority 3 (to be started within 24-48 hrs) and Priority 4 (an urgent or bumped elective case). Cases are performed in order of priority ranking and within priority ranking by time of booking. Surgeons may upgrade their case based on clinical need.

METHODS

The data was collected using a custom report developed by us with I-Path systems (Knoxville, Tennessee) using their ORMIS Operating Room software. Data was collected for all scheduled and unscheduled cases for the period April 1, 2000 to November 9, 2000. Patient in room times were compared to original booking times to develop the performance report. A benchmark of 95% compliance to expected start time was chosen as our quality assurance measure.

RESULTS

Workload is shown in the table Unscheduled Cases. The majority of unscheduled cases were Priority 3 (56%). The performance to benchmark for unscheduled cases is shown in the table Performance Benchmarks. The only Priority class where we reached the benchmark was Priority 3. Case start times for 95% of all cases done were significantly prolonged for Priority 1 and 2 cases. Five percent of all unscheduled cases were upgraded one priority ranking.

The largest group of cases (Priority 3) meet our benchmark. A large number of these cases are performed in protected emergency times during the day. The Priority 2 category cases may be subject to queuing in less well resourced hours. It is likely that a combination of increased after hours resources and revaluation of the category ranking will be needed to improve performance in this priority grouping. The poor performance of the "stat" category needs further evaluation. This report is a subset of OR benchmarking reports being developed for our hospital wide quality assurance program.

This Article Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by O'Connor, J.P. Articles by Dulovic, G. Search for Related Content PubMed Articles by O'Connor, J.P. Articles by Dulovic, G.