Aligning Interprofessional Team Training with LEAN Process Improvement to Reduce Operating Room Turnover

Addressing the selected theme:
One approach to align education and practice is to promote a culture of collaboration and continuous quality improvement. Interprofessional education and collaborative practice (IPECP) advances the concepts of collaboration, patient safety, and quality improvement, leading to improved health outcomes. These concepts support the Lean goals of eliminating defects and waste (patient safety issues and workforce inefficiencies) through interprofessional team training within the health system.

Using IPECP and Lean methodology synergistically, a project was initiated to increase interprofessional teamwork and decrease average Main OR (MOR) turn-over time for General Surgery by 15%. MOR turn-over time was defined as patient out to patient in. Reducing OR turn-over time has been associated with increased patient and team member satisfaction, enhanced quality of care, optimized teamwork, and improved cost-effectiveness.

The MOR team members assessed their duties, clarified their roles, and proposed strategies to address identified opportunities for improvement. An IPECP simulation was created and videotaped in-situ to test these proposed strategies. The OR team reviewed the videotape, made improvements in the proposed strategies, and repeated the simulation employing the improved workflow process. This approach of using IPECP and Lean synergistically allowed for evaluating strategies safely, making improvements in processes, and estimating the effectiveness of alternative strategies prior to actual implementation.

Description of outcomes:
The MOR team’s tested new workflow dramatically decreased MOR turn-over time for general surgery patients. Currently MOR General Surgery turn-over time is a mean of 43.6 minutes compared to 61 minutes at baseline (28.5% decrease), thus potentially increasing patient and team member satisfaction, enhancing the quality of care, optimizing teamwork, and improving cost-effectiveness. Extrapolating from this real-world exemplar, utilizing IPECP and Lean synergistically for interprofessional team training is one approach to align IPE and practice, optimize the clinical learning environment, transform the workforce, and create health system change.