Fahrenkopf Matthew P, Eichhorn Mitchell G
Spectrum Health-Michigan State University Integrated Plastic Surgery Residency, Grand Rapids, Mich.
University of Arizona College of Medicine, Hand and Microsurgery Fellowship, Phoenix, Ariz.
Plast Reconstr Surg Glob Open. 2019 Feb 8;7(2):e2111. doi: 10.1097/GOX.0000000000002111. eCollection 2019 Feb.
Plastic surgeons experience unique quality issues related to the specialty nature of patient procedures. Lack of accessibility to specialty supplies is a rate-limiting variable that impacts treatment efficiency and hospital resources. This study had the following goals: (1) to develop a mobile plastic surgery cart and (2) to assess the impact of a plastic surgery cart on time to treatment of consults.
Two plastic carts were developed using preexisting hospital supplies. Cart composition was designed and approved by hospital staff. A prospective study was conducted to assess overall time to treatment of patient consults throughout the hospital comparing a plastics cart versus a traditional hunt and gather methodology. One surgeon recorded time to treatment with and without the plastics cart for each consult during on-call duty hours over a 6-month period.
A total of 40 patients were treated for either head or neck (60%) or hand-related (40%) cases. The average time (minutes) to treatment across all procedures with the plastics cart was 3.7 ± 1.9 versus 46.3 ± 60.0 without the plastics cart. The maximum time to treatment was 9.5 minutes with the plastics cart and 3 hours without the plastics cart. Usage of the plastics cart resulted in a significant reduction in total time to treatment of 42.5 ± 60.3 minutes ( < 0.0001).
A specialty supplies cart has quality improvement implications for patients, physicians, and hospitals. Increased accessibility of specialty supplies may significantly reduce the time to treatment for plastic surgery patient consults throughout a hospital.
整形外科医生面临与患者手术专科性质相关的独特质量问题。专科用品获取不便是一个限制因素,会影响治疗效率和医院资源。本研究有以下目标:(1)开发一个移动整形外科推车;(2)评估整形外科推车对会诊治疗时间的影响。
使用医院现有的用品制作了两辆塑料推车。推车的组成由医院工作人员设计并批准。进行了一项前瞻性研究,比较在整个医院使用塑料推车与传统的寻找和收集方法时患者会诊的总体治疗时间。一名外科医生记录了在6个月的值班时间内,每次会诊使用和不使用塑料推车时的治疗时间。
总共治疗了40例患者,其中头部或颈部病例(60%)或手部相关病例(40%)。使用塑料推车时,所有手术的平均治疗时间(分钟)为3.7±1.9,而不使用塑料推车时为46.3±60.0。使用塑料推车时最长治疗时间为9.5分钟,不使用塑料推车时为3小时。使用塑料推车使总治疗时间显著减少了42.5±60.3分钟(<0.0001)。
专科用品推车对患者、医生和医院的质量改进具有重要意义。专科用品获取的便利性提高可能会显著缩短整个医院整形外科患者会诊的治疗时间。