Quality, safety and efficiency in practice: Risk assessment and standardisation of anesthesia equipment and supplies in operating theaters of high-volume tertiary-care academic medical center

Abstract

Background: Operating theatres (OTs) are valuable and costly resources that need to be appropriately designed and stocked for efficient, quality and safe patient care. We assessed the logistic inefficiency including the availability and location layout of necessary supplies across OTs of a high-volume tertiary-care academic medical center. Methods: A blinded observer (anesthesia technologist) was allocated to 10 OTs. For each OT, the availability, quantity and time spent to locate and obtain a set of required items were recorded (baseline values). We then developed an OT mapping plan to determine the specific item/s to be stocked in specific locations, and one OT was standardized to this configuration map. A blinded observer was then allocated to this standardized OT and time spent to obtain the same set of items was again recorded. Six of our regular OTs were then standardized to the same configuration, and the time to obtain the items by a blinded observer were again recorded for each OT. T tests compared the time required to locate items in the standardized OT vs. regular OTs; paired t tests compared the time required in each OT vs. itself before and after standardization. Results: The observer required significantly more time in each of the 10 regular OTs compared to the standardized OT. The time spent by the observer to obtain the required items significantly and considerably decreased in each of 6 OTs after their standardization, compared to the time required before their standardization. Conclusion: This quality improvement project successfully reduced the time required to identify and locate different supplies, which impacts on the efficiency and quality of patient care. For anesthesia staff moving from one anesthetizing location to another within the institution, consistencies in location and number of anesthesia equipment and supplies create higher levels of safety and professionalism.