title: On the day of surgery: how long does preventable disruption prolong the patient journey?
abstract: OBJECTIVE
  Disruption considerably prolongs session times for surgery, affects the quality of patient care, and prolongs waiting lists. In addition, there is a strong relationship between disruption and surgical error. This research aims to provide a platform for healthcare services to identify the sources of preventable disruption affecting operative time within the perioperative process and to effectively reduce it.
  
  
  METHODS
  Events inside and outside operating rooms that disturb the operative time were recorded for 31 elective surgeries over the period of five months. Disruption events were classified according to the hospital's requirements and the findings were reviewed by the surgical teams. Lean thinking approaches were used to achieve the purpose of this study.
  
  
  RESULTS
  Preventable disruption caused an increase in surgical time of approximately 25 per cent. Preventable disruption consisted of poor information flow, failure to follow concepts of methods study, lack of communication and lack of coordination. Coordination failures were the main reason for disruption followed by the lack of following the principles of motion economy.
  
  
  CONCLUSIONS
  Surgical disruption has substantial financial implications for hospitals. This research indicates that it is possible to reduce operative time considerably by eliminating preventable disruption. Such additional time could be utilised to deal with the pressure of emergency cases, reduce the waiting lists for elective surgery, increase operating room utilisation, and reduce medical errors.
authors: University of Southern Queensland, Toowoomba, Queensland, Australia. hakim@usq.edu.au
authors: Latif
authors: L
authors: Al-Hakim
authors: Xiao Yan
authors: XY
authors: Gong
mesh_terms: D003142:Communication; D003266:Continuity of Patient Care; D017598:Efficiency, Organizational; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D010346:Patient Care Management / Q000379:methods*; D019990:Perioperative Care / Q000379:methods*; D017064:Process Assessment, Health Care; D058996:Quality Improvement / Q000458:organization & administration*; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data*; D013997:Time Factors; D057188:Workflow