Introduction
Bayhealth healthcare system, with hospitals located in Dover and Milford, is Delaware’s leading healthcare system dating back to the 1900s. The system’s leadership is committed to the mission of “strengthening the health of the community, one patient at a time.” Bayhealth provides a wide range of services, inpatient care, and a plethora of outpatient services at both facilities with access to 24-hour emergency departments. The ultimate long-term strategy is to leverage the case volume and upgrade surgeon satisfaction through cultural transformation of perioperative services throughout the system
Situation
Operating room personnel routinely delayed cases, reporting holes in wrappers and missing and broken instruments. Surgeons were reporting evidence of bio-burden on instruments to leadership. Although continual errors were reported, there was no mechanism for auditing in place to determine the root cause of the errors. IUSS processes were higher than national benchmark levels with no documented evidence of the reason. The sterile processing department was suffering from a staff shortage and high turnover in staff and leadership.
The results of the issues were exhibited throughout the system operating rooms. SPD was responsible for sterilization of 15 operating rooms at two hospitals and an ambulatory surgery center located adjacent to the main hospital and several clinic sites. In the midst of the acute problems, the system was building a new hospital. The system needed SPD staff to be trained and prepared for certification and insights of how to organize the department to run more efficiently. Moreover, leadership needed to regain the trust of surgeons and the community. Senior leadership recognized the acuity of the situation and reached out to Surgical Directions to help stabilize the department and provide a short and long-term plan of action.
Solutions
To address the complex systemic issues, Surgical Directions recommended a multifaceted approach including building a culture of safety, developing robust SPD processes, and providing educational resource guidance:
- Deploy interim subject matter experts to work side by side with staff members
- Stabilize the SPD department’s daily operational challenges
- Launch a formal assessment of the workflow processes and staff members skillsets
- Conduct Surgeon and Staff Townhall meetings to establish transparent messaging across the enterprise
- Assemble performance improvement teams, administration, surgeons, nurses, anesthesia, and staff included in the transformation
- Develop dashboard metrics reports to support recommendations for change
- Install lean daily management boards to measure safety
- Conduct a job fair to recruit and fill open positions with SPD professionals
Results
The department transformation was led by the Surgical Directions team in close collaboration with senior leadership.
- Built a staffing plan to meet productivity goals. (See Staffing Plan table below.)
- Reduced traveler expenses by hiring 12 full-time employees. In addition, sourced candidates to hire a department manager and two supervisors, one for each facility. Trained employees to become more efficient
- 79% reduction of department errors:
- Holes in wrappers
- Missing or wrong instrument
- Incorrect Assembly
- Missing tray/set
