Charles Hubert Blouin-Delisle, Renee Drolet, Serge Gagnon, Stephane Turcotte, Sylvie Boutet, Martin Coulombe and Eric Daneau
The purpose of this paper is to increase efficiency in ORs without affecting quality of care by improving the workflow processes. Administrative processes independent of the…
Abstract
Purpose
The purpose of this paper is to increase efficiency in ORs without affecting quality of care by improving the workflow processes. Administrative processes independent of the surgical act can be challenging and may lead to clinical impacts such as increasing delays. The authors hypothesized that a Lean project could improve efficiency of surgical processes by reducing the length of stays in the recovery ward.
Design/methodology/approach
Two similar Lean projects were performed in the surgery departments of two hospitals of the Centre Hospitalier Universitaire de Québec: Hôtel Dieu de Quebec (HDQ) and Hôpital de l'Enfant Jesus (HEJ). The HDQ project designed around a Define, Measure, Analyse, Improve and Control process revision and a Kaizen workshop focused on patients who were hospitalized in a specific care unit after surgery and the HEJ project targeted patients in a post-operative ambulatory context. The recovery ward output delay was measured retrospectively before and after project.
Findings
For the HDQ Lean project, wasted time in the recovery ward was reduced by 62 minutes (68 percent reduction) between the two groups. The authors also observed an increase of about 25 percent of all admissions made in the daytime after the project compared to the time period before the project. For the HEJ Lean project, time passed in the recovery ward was reduced by 6 min (29 percent reduction).
Originality/value
These projects produced an improvement in the flow of the OR without targeting clinical practices in the OR itself. They demonstrated that change in administrative processes can have a great impact on the flow of clinical pathways and highlight the need for comprehensive and precise monitoring of every step of the elective surgery patient trajectory.
Details
Keywords
Stéphane Brutus, Roshan Javadian and Alexandra Joelle Panaccio
The purpose of this paper is to investigate the impact of various commuting modes on stress and mood upon arrival at work.
Abstract
Purpose
The purpose of this paper is to investigate the impact of various commuting modes on stress and mood upon arrival at work.
Design/methodology/approach
Data on stress and mood were collected after 123 employees arrived at work by bike, car, or public transit. In order to account for the natural fluctuation of stress and mood throughout the day, the assessment of the dependent variables was made within the first 45 minutes of arrival at work.
Findings
As hypothesized, those who cycled to work were less stressed than their counterparts who arrived by car. However, there was no difference in mood among the different mode users.
Practical implications
A lower level of early stress among cyclists offers further evidence for the promotion of active commute modes.
Originality/value
This study underscores the importance of being sensitive to time-based variations in stress and mood levels when investigating the impact of commute modes.