Before June, VUMC had a big problem with big beds: they don’t fit in all of the hospital’s operating rooms. Scheduling mishaps were discovered the hard way, right at the operating room door, causing delays and headaches for patients and clinicians. However, as of June 24, VUMC solved that problem through a collaboration between the eStar OpTime/Anesthesia team and our perioperative services leadership. They developed a system that alerts schedulers to the bed and operating room mismatch, and does not allow patients in a bariatric bed or above a weight threshold to be scheduled in an incompatible operating room.
On Wednesday, May 13, the eStar OpTime/Anesthesia team received a request from Dora Haney-Snider BSN, RN, CNOR, Interim Manager of Perioperative Services, after an incident that resulted in a procedure starting late. A critically ill, morbidly obese patient was scheduled for urgent surgery. When the anesthesia team arrived, they discovered that the patient was on a bariatric bed which couldn’t physically be brought into the scheduled OR. The case had to be moved to a different OR, resulting in a delayed start.
“Historically,” Haney-Snider said, “the communication related to the use of bariatric beds has been lacking. This is an issue due to the fact that many of our operating suites within the VOR have a single panel door that is not wide enough to accommodate the width of the bariatric beds. This issue requires the patient to be transferred to a stretcher that may not accommodate the patient’s weight, causing a patient safety issue, in order to transport the patient into the room.”
Jonathan Wanderer, MD, MPhil, Medical Director of Perioperative Informatics, said the eStar OpTime/Anesthesia team worked to create a workflow-friendly solution for the end user. “The initial request was to add an icon to the eORBoard,” he said. “The solution would have required the scheduler to look at the eORBoard, see the icon, and realize that they were putting the case into a room that wouldn’t support it.”
Jo Ann Howell, Principal Application Analyst for the eStar OpTime/Anesthesia team, collaborated with our clinical leadership to develop this system. Staff were in communication during the analyzing phase, planning phase, testing phase, demo phase, and approval phase. Even after the system went live, the communication doesn’t stop there. Howell said the eStar team will provide support as needed and follow-up to ensure everything is working as desired.
“This hard stop alert has essentially fixed this issue,” Wanderer said, “and is a nice example of our operational team working with HealthIT in designing practical solutions that allow our clinician teams to reliably execute on efficient clinical care.”