The Crimson Press Curriculum Center

First Page and the Assignment Questions:
PeriOptimum is a valuable tool that we use today and plan to use in the new Orthopedic Center to improve the utilization of surgical operating rooms for orthopedic patients, reduce the time a patient is in surgery, and greatly enhance physician and patient satisfaction

   The speaker was Melissa McNamara, Chief Operating Officer of Laverne General Hospital (LGH), and the person charged with overseeing the implementation of Laverne’s Orthopedic Center, one of five centers that were considered service lines with bottom-line responsibility within the hospital.

   The Orthopedics Center represented an important strategic move for Laverne. Not only did it mean that the hospital would be in closer partnership with its surgeons, five of whom were on the Center’s steering committee, along with an anesthesiologist, but, in many respects, the center was a move toward greater use of a team approach in the hospital’s operating rooms. Although the hospital was counting on PeriOptimum (PO) to be the catalyst for the whole effort, it was clear to many senior managers that PO needed to be supported with a solid complement of management systems. In the words of Ms. McNamara:

   We needed to make a move in orthopedics. The product line is in demand, and a lot of procedures can now be done in an outpatient setting, which makes it easy for the for-profit folks to steal business from us. There’s also a revolution in joint care. What was once a 5-day hospital stay with a 6-week recovery period is now a 1-day stay with a 6-day recovery period.

   She continued:

   The orthopedic surgeons are also changing. Some now want to do eight cases a day, although it’s hard to predict the OR time needed for each case. In this regard, PeriOptimum has led to a lot of shakeups in the hospital. We have been able to better manage OR block time assignments2 and have a good sense of who uses a block effectively and who does not. We’ve also established the OR Governance Committee as a key decision-making group to deal with OR issues. What we’ve not done so far is to decide if a team approach to the ORs is a workable idea. So the Ortho Center will play that role. Each team will consist of a surgeon, an anesthesiologist, an RN [registered nurse], an assistant, and a technician. The goal is to have them learn to work cohesively to improve throughput in the ORs without, of course, jeopardizing quality.

BACKGROUND

   LGH opened in 1893 as a three-story brick residence with a mission to deliver the best possible care to anyone in need, regardless of ability to pay. Ten years later, LGH established a nurses training school. The institution grew steadily over the next hundred years. In 1992, it finished construction on its “Health Campus,” an outpatient center with physicians’ offices, lab and testing facilities, and ambulatory surgery. In 2000, it opened the Women and Babies Hospital, an attractive and inviting facility adjacent to the Health Campus. During the summer of 2003, ground was broken for the Orthopedic Center, a multi-million dollar, state-of-the-art facility, due to be opened in November 2004.