With the increasing spread of COVID-19 infections, the governor of Arizona declared a moratorium on “elective surgical treatments” on March 19, 2020, in order to save hospital PPE supplies and build capability for possible COVID-19 clients requiring hospitalization.
The moratorium lasted for six weeks and was finally raised on May 1,2020 Completion of the suspension led to a backlog of more than 3,000 surgical procedures at Phoenix Children’s Healthcare facility.
THE ISSUE
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” While it holds true that elective surgical treatments are generally nonurgent, a number of these are medically required and important for a kid’s health and wellness,” discussed Dr. Vinay Vaidya, chief medical info officer at Phoenix Children’s Hospital.
” Besides the delay in surgical treatment for the patient, deferring all elective surgeries put a major monetary strain on health centers throughout the country. The difficulty we needed to address was how to resume the countless delayed surgical treatments, in addition to the new surgeries that were being added every day.”
These operations required to be carried out in a timely and efficient manner while making sure utmost safety for patients and doctor. The scheduling of surgical treatments is an intricate procedure that involves lots of players and needs a series of sequential and synergistic actions. The COVID-19 pandemic added magnitudes of intricacy to each step in this procedure.
” This was an unprecedented circumstance that needed coordination throughout our whole system of care, from executive leadership to surgeons, anesthesiologists, nursing personnel, operating space personnel, schedulers, and eventually clients and their households,” Vaidya said.
” We needed to construct a common communication highway, based on infotech, that would offer real-time presence through the whole scheduling procedure, and to all stakeholders.”
PROPOSITION
Once the moratorium on optional surgical treatments was raised, the procedure of rescheduling the backlog of more than 3,000 cases might begin.
Clearly, what was required was far more than just tossing extra scheduling personnel to overcome the stockpile one client at a time, Vaidya said. In the middle of a pandemic, staff had to reword the rules of how a surgical scheduling process would unfold.
” Based upon our previous experience of effectively utilizing information technology in general, and information analytic control panels in specific, it was evident at the very beginning that we would require a similar method to attend to the complex logistics,” he said. “The solution to resuming these surgical treatments was the advancement of a proprietary dashboard, which could assist in the whole triage of operations.”
FULFILLING THE CHALLENGE
Provided the challenges positioned by COVID-19, it was necessary to think about a number of elements such as: the type of surgical treatment, medical need and need for hospital/ICU remain, Vaidya discussed. These components required to be balanced with the availability of PPE, sufficient staffing, general and ICU bed availability, and ventilator availability, while making sure the greatest standards of security for clients and healthcare facility personnel.
” Using a cautious and well-planned approach, a surgical prioritization was developed and consistently interacted to all surgical teams,” Vaidya stated.
As this information was captured electronically, it was utilized to feed a different control panel produced particularly for the schedulers, who discovered it easy to work through the list, based on surgical priority. This significantly enhanced the efficiency of the procedure, enabling personnel to arrange a much greater variety of clients every day than formerly possible.
” The innovation allowed for synergies across the business in addressing the complex challenges of resuming these operations.”
Dr. Vinay Vaidya, Phoenix Children’s Medical facility
” For those patients who were successfully arranged for surgical treatment, it was mandatory to evaluate them for COVID-19 in the 72 hours preceding the date of surgical treatment,” Vaidya kept in mind.
” This process was likewise facilitated utilizing the control panel, which displayed the patients who were scheduled for COVID-19 testing, those who completed the test, and those who tested unfavorable and were lastly cleared for surgical treatment. It likewise identified patients who tested positive for COVID-19 and needed to have their surgeries postponed.”
The whole end-to-end electronic process offered a single enterprise-wide view that enabled structured tracking of the client throughout the numerous actions, not unlike that of an Amazon bundle, right from buying to final delivery, Vaidya described.
” This also anticipated the requirement for inefficient and lengthy internal communication via emails, call and spreadsheets in between the surgeons, operating space personnel and the schedulers,” Vaidya said. “The control panel hence ended up being the de facto main center and the single source of fact, updated in genuine time, and extensively used throughout the whole company, from the frontline staff right as much as senior leadership.”
Vaidya included that it is necessary to mention that the hospital had the ability to accomplish all of this extremely quickly.
” We already had in place an existing robust information warehouse structure that was getting feeds from practically every info system utilized in the hospital, consisting of live feeds from our EHR,” he said. “In addition, much of the data needed for the control panels had currently been prepackaged into ready-to-use analysis cubes that had actually been previously built for other surgical jobs preceding COVID-19”
Finally, a couple of information experts who were already competent in rapidly developing visually helpful, interactive, actionable control panels utilizing Microsoft’s Power BI software, were able to provide the control panels in record time.
RESULTS
The one success metric of this job that stands apart is that the hospital was not just able to catch up rapidly on the backlog of surgeries, but in fact wound up performing 166 more surgical treatments in June and July of this year, compared to the very same period in 2015 — 4,199 versus 4,033 — Vaidya reported. This volume talks to the technique: a substantial use of information, analytics and dashboards to support every phase of the procedure, from surgeon prioritization to scheduling, testing and lastly surgical treatment, he included.
” Among the many types of surgeries carried out during this challenging duration, it deserves highlighting the results of our surgical volumes for two very intricate surgical treatments,” he said.
” Phoenix Kid’s Healthcare facility is nationally acknowledged as a center of excellence, and draws patients from all across the nation for Pectus surgical treatment, done to remedy chest wall deformities, and Scoliosis surgery, to remedy irregular spine curvature. Both are complicated, long-duration surgeries that need a healthcare facility stay, and are frequently organized months beforehand to accompany school summer season break.”
When it comes to Scoliosis surgical treatment, the hospital prospered in performing more surgical treatments this year throughout May through August compared to the exact same period in 2015, 95 versus91 The results for Pectus repair surgical treatment were much more notable. The surgical teams outperformed by 41%the variety of surgeries performed this year from May to August compared with the exact same period last year, 72 versus 51.
” The technology enabled synergies throughout the enterprise in resolving the multifaceted obstacles of resuming these operations,” Vaidya said. “Throughout this job, given that patient and supplier safety was our highest top priority, it is necessary to point out that no surgeon or anesthesiologist has actually tested favorable for COVID-19 given that surgery restarted — a testimony to substantial safety procedures that were supported by dashboard use at every stage.”
GUIDANCE FOR OTHERS
The success of this job no doubt depended upon the collaboration and cooperation of various groups, Vaidya stated. Its structure was constructed upon the optimum use of information analytics, and dashboard technology, to offer precise, real-time, actionable info to all the key players, he added.
” Fortunately, many healthcare facilities and health systems have actually established their electronic abilities over the last 10 years and are sitting on a trove of data,” he stated.
” Making sure that the multiple, frequently diverse, info systems in a health center setting all feed their information to a common information warehouse platform permits optimal usage of this data,” he discussed. “Mining the data, and offering it to frontline users via user-friendly interfaces, turns it into actionable intelligence that produces results.
” As IT specialists, we have been guaranteeing our health companies that information can be utilized to produce higher quality results,” he added. “Using innovation in the resumption of surgeries is a best example of providing on this pledge.”
Twitter: @SiwickiHealthIT
Email the writer: bsiwicki@himss.org
Healthcare IT News is a HIMSS Media publication.
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