title: Improving on-time start for iMRI neurosurgeries.
abstract: BACKGROUND
  In the Singapore General Hospital, intraoperative MRI (iMRI) neurosurgery is a multi-disciplinary process that involves staff from multiple departments. However, a baseline analysis showed that only 10.5% of iMRI neurosurgeries start on time, resulting in unnecessary waste of resources. The project aimed to improve the percentage of on-time start iMRI neurosurgeries to 100% within nine months.
  
  
  METHODS
  Clinical Practice Improvement methodology was used. The project involves four phases: Diagnostic, in which a baseline analysis is conducted; Intervention, in which problem areas are identified; Implementation, in which potential solutions are implemented; and sustaining, in which strategies to sustain gains are discussed.
  
  
  RESULTS
  The percentage of on-time start cases gradually increased to 100% in eight months, and was sustained above 85% in the following five months.
  
  
  CONCLUSIONS
  This project serves as a successful demonstration of how quality improvement can be effected in a complex, multidisciplinary workflow, which is the norm for many hospital procedures.
authors.affiliation: Department of Anaesthesiology, Singapore General Hospital, Singapore.
authors.forename: Natascha Fherzinah Rustom
authors.initials: NF
authors.lastname: Ghadiali
authors.forename: Darren
authors.initials: D
authors.lastname: Koh
authors.forename: Kuok Wei
authors.initials: KW
authors.lastname: Chia
authors.forename: Shin Yi
authors.initials: SY
authors.lastname: Quek
keywords: Clinical practice improvement; Singapore healthcare; intraoperative magnetic resonance imaging; neurosurgery; quality improvement