Ghadiali Natascha Fherzinah Rustom, Koh Darren, Chia Kuok Wei, Quek Shin Yi
Department of Anaesthesiology, Singapore General Hospital, Singapore.
Asian J Neurosurg. 2013 Jan;8(1):2-8. doi: 10.4103/1793-5482.110270.
In the Singapore General Hospital, intraoperative MRI (iMRI) neurosurgery is a multi-disciplinary process that involves staff from multiple departments. However, a baseline analysis showed that only 10.5% of iMRI neurosurgeries start on time, resulting in unnecessary waste of resources. The project aimed to improve the percentage of on-time start iMRI neurosurgeries to 100% within nine months.
Clinical Practice Improvement methodology was used. The project involves four phases: Diagnostic, in which a baseline analysis is conducted; Intervention, in which problem areas are identified; Implementation, in which potential solutions are implemented; and sustaining, in which strategies to sustain gains are discussed.
The percentage of on-time start cases gradually increased to 100% in eight months, and was sustained above 85% in the following five months.
This project serves as a successful demonstration of how quality improvement can be effected in a complex, multidisciplinary workflow, which is the norm for many hospital procedures.
在新加坡中央医院，术中磁共振成像（iMRI）神经外科手术是一个涉及多个部门工作人员的多学科流程。然而，一项基线分析显示，只有10.5%的iMRI神经外科手术按时开始，造成了资源的不必要浪费。该项目旨在在九个月内将iMRI神经外科手术按时开始的比例提高到100%。
采用临床实践改进方法。该项目包括四个阶段：诊断阶段，进行基线分析；干预阶段，识别问题领域；实施阶段，实施潜在解决方案；维持阶段，讨论维持成果的策略。
按时开始手术的病例比例在八个月内逐渐提高到100%，并在接下来的五个月内维持在85%以上。
该项目成功展示了如何在复杂的多学科工作流程中实现质量改进，而这正是许多医院手术流程的常态。
