Authors (including presenting author) :
Ngan HT(1), Lee SL (1), Ip LH(1), Fung CK(1), Ngai YY(1), Cheng HK(1)
Affiliation :
(1)Department of Anaesthesia & Operating Theatre Services
Introduction :
Operating room is recognised as a high-cost and high-risk unit inside a hospital. The resources inside the OR in often poorly utilised. Proper management of the operating room suite is important so that patients can get safe, quality and efficient care. OR management is responsible for the coordination of different components of the operating room in order to optimise patient outcome, surgeon needs and minimise patient delay while maximising resource efficiency including OR staff (nurses, anaesthetic assistants, orthopaedic assistants, radiographists, OR cleaning team and even clerks), equipment (X-ray machines, different TV system and even different anaesthetic machines) and time. Effective OR management has become essential for service stability and resources utilisation. OR manager/ IC often need to make many decisions before the day of surgery. They need to allocate different equipment, staffing and operating room according to the kind of surgery and the duration of the surgery. OR manager/ IC are also responsible for many last minute decision-making. They need to determine which operating room should perform add-on cases and emergencies. In Tseung Kwan O Hospital, there are in total 8 operation rooms working every day. Originally, we use a whiteboard with the staff name tag attached by a magnet to do our staff assignment. The staff assignment board need to be reset every day. It takes nurse IC over 1.5hours to change the name tag to next day duty assignment every day. The whiteboard is unclear and there is no interactive information given back to the nurse IC. Moreover, with the increasing number of operation section and staff. It is foreseeable that the white board will no longer corp with our service demand. Last but not least, our nurse IC often need to use their personal experience to make many last minute decision. They often need to gather information from around 3 to 5 clinical systems in order to have their final decision. This will be a stressful task as they need to manage 8 operation rooms at the same time. Therefore we develop our smart dashboard to help our nurse IC to assist them in decision making and operation management.
Objectives :
TKOH OT Smart Dashboard is developed to help nurse IC in the following area. 1. Solving the staffing problem 1.1 Connect with HA SRS system for staff duty roaster to reduce every day changing staff assignment board 1.2 Get the real-time information on staff availability 1.3 Easy assign staff from 1 operation room to another 1.4 Next Day OR staff arrangement (suggest suitable staff to every room) 1.5 Connect with our PNIS and HA OTMS to have the latest operation room situation 2. Solving the equipment allocation problem 2.1 Clearly display which machine is occupied in operation room 2.2 Prior allocation of the delicate machine to the specific operation room 3. Reduce the number of telephone call 3.1 Send out non-critical information to Smart TV installed in operation room 3.2 Connect with our PNIS and HA OTMS to have the latest operation room situation
Methodology :
The TKOH OT Smart Dashboard is installed in Jan 2018 There are many features that can assist nurse IC to finish daily operation smoothly and efficiently. The TKOH OT Smart Dashboard consist with a 28-inch Touchscreen Surface Studio as a control console. There is a 65 inch Smart TV as our display. All of them are connected with our third party medical network through Wifi so that different system especially our perioperative nursing information system can link up together to share information between different systems. 1. Availability of staff and equipment We have assigned one RFID tag to all of our working staff and equipment. The RFID tag is used for tracking the availability of different staffs and machines inside the operating room. The availability is now shown by "light up" on the monitor screen, Moreover, the Smart-Dashboard is connected with PNIS, the nurse role like scrub nurse and circulating nurse can be shown on the display. With the real-time data of staff status. Nurse IC is therefore easily managing staff from different operating rooms. 2. User-friendly touchscreen control and interactive icons The control console is a large touchscreen computer, this allows nurse IC to make their decision immediately. We have designed a number of icons to help nurse IC to do the day-by-day operation. For example, we have designed a "rice" icon to help nurse IC to arrange staff meal time. Once the meal time is arranged, the information will display on the Smart TV screen inside our operating room. These measures can help reduce the telephone traffic of nurse IC. 3. Staff duty assignment Nurse IC often need to memorise staff competence, they need to memorise which staff can handle which case by their experience. With the Smart-Dashboard, we have integrated our Staff Competence system. The Smart-dashboard can then suggest the suitable and available staff to our nurse IC to choose. Moreover, nurse manager/ IC can arrange next day staffing now as the data from HA SRS is imported to Smart-dashboard. They can view the next day even next week available staff once the duty is confirmed.
Result & Outcome :
The Smart-dashboard is a great success to our daily operation. It helps gather different information from different systems and provides processed information and suggestion to our nurse IC in daily decision making. It is believed that the Smart-Dashboard helped a lot in daily operating room management. Moreover, with the feedback of our Nurse IC, the Smart-Dashboard is user-friendly, information is clearly displayed and they agree that the internal telephone communication reduced a lot. There is no doubt that the actual effect in operating efficiency is difficult to measure, however, we believe that with the help of Smart-Dashboard, we can increase our service stability and resource utilisation. We hope that with the help of the Smart-Dashboard, we can deliver our service more timely, efficiency and safety.
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