Eligible for: ACMPE: 1 | ACHE: 1 | CEU: 1 | CME(AAPC*): 1 | CPE: 1.2 | PDC: 1 Traditional | Intermediate | Analysis * This session is included in the 2025 MGMA Summit education program.
Process improvement techniques and Lean Six Sigma initiatives are common in healthcare organizations. In the perioperative arena, process improvement studies often examine patient flow before or after the surgery to reduce wait time, discharge the patient faster, or turn rooms over quickly. Improvement science rarely extends inside the operating room. But why? This presentation illustrates a Lean improvement initiative inside the OR to reduce operative time and increase the number of procedures completed. The hospital chose to study the efficiency of trans-aortic valve replacement (TAVR) procedures due to the long wait time patients experience before surgery. By directly observing the procedures, using temporal sequencing and spatial analysis, and comparing timestamp data for critical parts of the procedure, the hospital identified inefficiencies resulting in unnecessarily long operative times. Science, by way of data-driven decision-making, had illustrated the inefficiencies and opportunities for improvement in the TAVR procedure. Implementing corrective actions, however, required art. John Kotter's model, 8 Steps for Leading Change, proved to be the right approach to creating lasting change, as operative time was reduced, daily TAVR capacity increased from two to three procedures, patient wait time for surgery decreased, and total charges and revenue increased.
Learning Objectives:
Breakdown John Kotter's 8-Step model for change and its uses in process improvement initiatives
Examine operative procedure efficiency through the use of temporal sequencing and spatial analysis techniques
Point out the availability, or lack thereof, of benchmarks to compare internal operative times, and potential options for comparison if national benchmark data is not available