Your cataract surgeons are models of efficiency, but what about your pre- and post-op routines? Could you shorten your pre-procedure time between patient check-in and incision? What about your discharge time, between surgery's end and the patient's meeting discharge criteria? At the AAAHC Institute for Quality Improvement, Senior Director and General Manager Naomi Kuznets, PhD, has analyzed benchmarking data on both processes to identify potential areas of improvement.
Pre-procedure
Cataract surgery pre-procedure times range from 30 to 157 minutes, with an average of 83 minutes. Facilities with the shortest times credited the following:
Computerized charting with EMRs.
Patients administering dilating drops at home.
One nurse starts IVs while another handles charting, pre-op exams and interviews.
Standardized charting and routines to streamline the pre-op process.
High staff-to-patient ratio.
Teamwork and cross-training.
Benchmarking and continual process re-evaluation.
To keep your pre-procedure average times down, recommend appropriate patient arrival times, since early-arriving patients may have to wait longer than necessary, says Dr. Kuznets.
Discharge times
Discharge times ranged from 6 to 31 minutes, with an average of 24 minutes. Facilities with the shortest times credited the following:
Giving caregiver discharge instructions while patient is in surgery.
Using local anesthesia and only 2mg of midazolam.
Leaving patients in street clothes.
Utilizing 2 ORs to minimize turnover time.
Compiling medication reconciliation form at patient's pre-op visit.
Explaining discharge instructions at pre-op visit so patients are familiar with them during post-op review.
Staffing a nurse and tech to begin post-op care as soon as patients leave the OR.
Assigning a nurse to take vitals and monitor, a tech to review post-op instructions and a certified paramedic to remove the IV.
Escorting patients from the facility to prevent slips and falls.
David Bernard
