For Perioperative Services, change is in the air

Dr. Udelsman outlined future initiatives for the Perioperative Services Department at a recent leadership retreat.
Dr. Udelsman outlined future initiatives for the Perioperative Services Department at a recent leadership retreat.

With the Saint Raphael Campus integration, two Epic go-lives and continued growth of destination hospital services, Perioperative Services marked some major milestones in fiscal year 2013 — and more changes are on the way.

The department recorded 50,662 cases in 2013 on the York Street and Saint Raphael campuses and at Temple Medical Center. At the same time, it successfully implemented Epic on both campuses and opened a new Artis Zeego operating room on the YSC that gives surgeons the benefit of advanced imaging during surgical procedures.

"We're proud of how far we have come, and recognize there is more to be done to meet the needs of our patients and support the growth of our programs," said Cynthia N. Sparer, senior vice president, Operations, and executive director, Yale-New Haven Children's Hospital. "Perioperative Services physicians and staff have taken the lead on a number of initiatives to enhance safety, efficiency and patient and staff satisfaction."

Safety and quality are top priorities, said Robert Udelsman, MD, MBA, surgeon-in-chief, YNHH, and chairman, Department of Surgery, Yale School of Medicine. As part of a hospital-wide effort to become a high reliability organization (HRO), Perioperative Services directors, managers, employees and members of the medical staff will receive training in error-prevention techniques.

"We have embraced the HRO initiative as a key piece of our ongoing efforts to provide the best and safest care," Dr. Udelsman said. "By adopting the error-prevention tools and best practices used by other high reliability organizations, we're confident we'll meet our goal of eliminating incidents of preventable patient harm."

Several other changes are under way in the areas of leadership, nursing configuration, pre-admission testing, Epic optimization and communication:

  • A new vice president of Perioperative Services is being recruited to succeed Marjorie Guglin, RN, who will transition to her new position as vice president, Clinical Project Management.
  • The hospital is conducting a national search for a clinical chief of Perioperative Services, a new leadership role to serve as the liaison with Surgical Services leadership and oversee Perioperative Services development.
  • In December, Katherine Marschall, MD, was appointed physician leader for pre-admission testing. Dr. Marschall is working with Surgical Services leadership to create consistency in pre-admission testing criteria and assist with a pre-admission testing redesign to ensure that service is efficiently meeting patients' and surgeons' needs.
  • YNHH is conducting a search for the next director of nursing for Perioperative Services on the York Street Campus to fill this important role and join the new Perioperative leadership team. Epic optimization remains another key focus area. Information Technology Services (ITS) staff are currently linking all related documents for each patient, including consent forms, medical history and pre-op orders, so they are clearly associated with the case and easy to locate and view. 

Perioperative Services will also work with ITS to develop metrics and other tools to assess operating room performance across all sites.

In the spring, Perioperative Services will begin implementing specialty-based nursing clusters across the YSC, SRC and Temple Medical Center to improve operating room efficiency and enhance surgeon and employee satisfaction. The department has defined areas of focus for the clusters; cluster leaders will be appointed in the coming weeks.

"This is a time of important change in Perioperative Services, and staff and physicians are devoting a substantial amount of effort to ensure the success of these initiatives," Sparer said. "We are all committed to making our operating rooms among the safest, highest-performing and most patient-centered in the country."