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The study of the effectiveness of change in practice with the implementation of the perioperative surgical home model
Descriptive
TitleInfo
Title
The study of the effectiveness of change in practice with the implementation of the perioperative surgical home model
Name
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Enyaosa
NamePart
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Cordelia H.
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Cordelia H. Enyaosa
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author
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Avadhani
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Amita
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Amita Avadhani
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Advisory Committee
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chair
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Rutgers University
Role
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degree grantor
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School of Nursing - RBHS
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school
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Text
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theses
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DateCreated
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2019
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2019-01
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2018
Language
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(authority = ISO 639-3:2007);
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English
Abstract
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Purpose: Operational cancellations have placed a significant burden on healthcare providers. This study aims at performing an analysis of findings with regards to the outcomes from a practice change at the Northern New Jersey Healthcare System (NNJHS) in terms of the volume of cancellations, delays, operating room (OR) lag time exceeding target threshold and inefficient OR utilization. This was with the aim of providing recommendations to improve the current perioperative surgical home (PSH) model.
Methodology: PSH program evaluation was undertaken using a retrospective chart review of the compare the before and after records to evaluate the anticipated outcomes of a PSH model. The two study groups were sourced from two sequential periods between the first six months of 2017 and 2018. Tests of significance was assessed with McNemar chi-square tests with the level of significance set at 95% confidence interval (p value <0.05).
Results: The overall cancellation rate in NNJHS dropped by 2.0% while the OR lag-time and first case on time starts increased by 14% and 3%. The OR utilization rate decreased by 5.3% following the implementation of the PSH model. Cancellations due to environmental and patient-related issues increased by 3.8% and 8.8% (p value <0.001). Cancellation due to health status dropped from 32.2% in 2017 to 24.7% in 2018 (p value <0.001).
Implications for Practice: The economic cost benefits of PSH model will help improve OR inefficiencies by decreasing overall cancellations and utilization rate. The financial benefits will help decrease hospital costs and increase workflow efficiency. The policy implication is when benchmarks set by the National Surgery Office (NSO) have not been reached resulting in a performance improvement plan or potential termination of employment.
Methodology: PSH program evaluation was undertaken using a retrospective chart review of the compare the before and after records to evaluate the anticipated outcomes of a PSH model. The two study groups were sourced from two sequential periods between the first six months of 2017 and 2018. Tests of significance was assessed with McNemar chi-square tests with the level of significance set at 95% confidence interval (p value <0.05).
Results: The overall cancellation rate in NNJHS dropped by 2.0% while the OR lag-time and first case on time starts increased by 14% and 3%. The OR utilization rate decreased by 5.3% following the implementation of the PSH model. Cancellations due to environmental and patient-related issues increased by 3.8% and 8.8% (p value <0.001). Cancellation due to health status dropped from 32.2% in 2017 to 24.7% in 2018 (p value <0.001).
Implications for Practice: The economic cost benefits of PSH model will help improve OR inefficiencies by decreasing overall cancellations and utilization rate. The financial benefits will help decrease hospital costs and increase workflow efficiency. The policy implication is when benchmarks set by the National Surgery Office (NSO) have not been reached resulting in a performance improvement plan or potential termination of employment.
Subject
(authority = local)
Topic
Perioperative surgical home model
Subject
(authority = RUETD)
Topic
Post-Master's DNP Practice
Subject
(authority = ETD-LCSH)
Topic
Health services administration
Subject
(authority = ETD-LCSH)
Topic
Surgical nursing
Subject
(authority = ETD-LCSH)
Topic
Patient-centered health care
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Rutgers University Electronic Theses and Dissertations
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ETD
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School of Nursing (RBHS) DNP Projects
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rucore10004500001
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ETD_9385
Identifier
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doi:10.7282/t3-5ac1-zz81
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application/pdf
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text/xml
Extent
1 online resource (101 pages) : illustrations
Note
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DNP
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Includes bibliographical references
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ETD doctoral
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Rights
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The author owns the copyright to this work.
RightsHolder
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Name
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Enyaosa
GivenName
Cordelia
MiddleName
H.
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Permission or license
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2018-12-02 19:56:27
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Cordelia Enyaosa
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Rutgers University. School of Nursing - RBHS
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Author Agreement License
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I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
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Embargo
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2019-01-31
DateTime
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2099-12-31
Detail
Access to this PDF has been restricted at the author's request.
Copyright
Status
Copyright protected
Availability
Status
Open
Reason
Permission or license
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2018-12-15T00:58:16
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2018-12-15T00:58:16
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