Operating Room Case Study

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New York University Hospital medical committee determined that the major cause of the delays in the Operating Room (OR) procedures was due to late arrival of surgeons. Similarly it was noticed the scheduling of cases at Johns Hopkin Aramco OR is a complex process, which involves the coordination of patient arrival and staff availability. This is particularly problematic for starting subsequent OR cases in a timely manner. Such delays lead to an increase in staff overtime and facility operating costs as well as a decrease in patient and employee satisfaction. There are several reason as listed below contribute for the delays, such as;
1. Operating Room and the staff not ready due to complexity of the case.
2. Patient related issue such as late
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To achieve this analysis, our team performed observations of patient arrival and surgery preparations. My team was able to develop recommendations to increase the accuracy of first case starting time and subsequent cases.
Background
Saudi Aramco is an oil company based in Saudi Arabia, within which an independent joint venture to provide patient care for employees and their dependents. The company has 55,000 employees and approximately 260,000 dependents with the expectation of high standard of patient care. There are facilities for inpatient and outpatient care. Johns Hopkins Aramco Hospital OR performs more than 8000 surgeries per year with a variety of specialties, including: Neurosurgery, Craniofacial Surgery, Otolaryngology, Ophthalmology, Plastic Surgery, Pediatric Surgery, Urology, and Orthopedic Surgery. The hours of operation for the Day Surgery Unit (DSU) are 0600 to 1900 hours, on regular Saudi Aramco working days. DSU patient admission times are to be staggered, utilizing 0600, 0630, 0800 and 1000 time slots on the instructions of the surgeon. The cut-off time for
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WIIFM (WHATS IN IT FOR ME)
2. Moving Stage is when it is possible to make changes. A knowledgeable, respected, or powerful person influences the change agent in solving the problems (Rouseel 2013 p135).
This is when I expected full on resistance, this stage I increased my meetings to 2-3 times a week, keep staff motivated by constant encouragement and support. (Chocolate and Joffrey coffee)
3. Refreezing stage is when the change is strengthened and becomes the new normal state. Changes are integrated and stabilized as part of the value system (Rouseel 2013 p135).
Constant re-evaluation is imperative at this stage, as I don’t want staff to go back to the old way.
Action Planning
As a team leader, we had an open door policy, the positive was, staff did come to me and voice their concern however there was one staff member who discussed this change with her colleague in very negative light. I took this staff member and gave one to one counselling and explained that in the long run the change would be beneficial for all. Weekly communication meetings with regard to change this period of the Lewin’s model of change. The positive to this was I had lot of staff participation, however over time their motivation decreased and I increased communication meetings 2-3 times a week to enable continuous

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