Wang Yi Chian
Kaohsiung Medical University, Republic of China
Posters & Accepted Abstracts: J Nurs Care
Introduction: As the improvement
of medical quality and technology,
patients expect high-quality
medical service, comfortable
environment and faster service
efficiency during medical
treatment. Day surgery has rapid
admission to discharge process and
short operation time. However,
it requires long waiting time and
lack of nursing health education.
The aim of this study was to
reduce waiting time and improve
satisfaction of medical care.
Methods: The study was conducted
from June 1, 2016 to June 30,
2017. There were 265 patients
undergoing day surgery and
surgery delay rate was 79%. The
patientâ??s satisfaction to day surgery
procedure was only 62.6%. The
cognition to surgical precautions
was only 56%; the postoperative
unplanned return rate was 3.2%.
The calculated process cycle
efficiency (PCE) was 8.85% by
examining value stream map. The
improvement plans included (i)
Introduce shared decision making
(SDM): design posters including
perioperative health education
and process, make shared decision
making manuals, revise universal
health education handouts,
produce a package with all health
education information, remind
patients with small cards and set up
a platform for one-by-one health
education by nurse specialists.
(ii) Cross-team education and
training: set up a health education
workshop, organize a health
education competition, arrange
continuous education, practice
simulation and online learning.
(iii) Construct a lean healthcare
day surgery process: process
optimization, a series of service,
I-PASS priority pass (I-PASS), ISBAR
(Identify, situation, background,
assessment and rcommendation)
handover, customized tourniquet
and process map. (iv) Construct a
case management tracking system,
post-operative tracking, health
education video in QR code, video
teaching, a health education group
in Line, multimedia digital signage,
health education in robot (Zenbo),
I-corner multi-function private
room.
Results: (a) The waiting time from
admission to the operating room
was reduced from 357 to 177
minutes, reaching our target value
of 50%. (b) The delayed delivery
rate decreased from 79% to 21%.
(c) The postoperative unplanned
return rate improved from 3.2 to
1%. (d) Patient satisfaction to the
day surgery process increased
from 62.6% to 98.2%, and staff
satisfaction also increased from
60.4% to 96%. (e) The PCE
improved from 8.85% to 24.7%
through lean healthcare.
Conclusion: Reduction of surgery
waiting time with improvement of
patient safety and satisfaction could
be accomplished by lean healthcare
and team resource management.
Patients and their family members
realized the value of hospital after
identifying day surgery problem
and modifying medical process. The
implement of perioperative health
education achieved understanding
of surgery process and reduced
anxiety.
Wang Yi hian has completed her Master degree at the age of 38 years from I-Shou University. Currently, she is working as a surgical nurse in the operating room of Kaohsiung City Hsiao-Kang Hospital. She had published more than 4 papers in Taiwan journals and published 10 posters.
E-mail: whawha0930@gmail.com
Journal of Nursing & Care received 4230 citations as per Google Scholar report
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