Surgical Planning to Improve Clinical Outcomes

Dr Jessica Kierath1

1Dr., Floreat, Australia

Abstract:

Background

Surgical planning allows visualisation of the procedure step by step. It increases awareness regarding the flow of the operation and highlights potential issues.

Longer surgery duration is associated with an increase in the rate of infection and length of inpatient stay. (Proctor;Saleh)

Specific to burns surgery an increased duration of surgery by 30 minutes equates to 13% increase in length of stay independent of %TBSA (Lim).

In surgery, as much as 30% of procedure-specific information may be lost as a result of miscommunication. (Lingard)

A study looking into interruptions in surgery found that the most distracting communications were those related to operating room equipment. (Sevdalis)

During the set up of the West Australian Burns Unit at Fiona Stanley in 2015, the was an opportunity to improve theatre efficiency and communication via the use of a surgical planning tool.

Our aim was to develop a surgical planning tool for all acute and reconstructive procedures.

Subsequent audit of the tool resulted in integration with our anaesthetic colleagues and further details relevant to peri and post-operative care

Results: Utilising the surgical planning tool improved intraoperative communication, minimizes patient time in theatre, and reduces theatre wastage.

Discussion: We have found the surgical planning tool to be integral to the running of the unit. The evolution of the tool has progressed to include all MDT members to enhance teamwork, communication, efficiency and patient outcomes.

  1. Procter LD, Davenport DL, Bernard AC, Zwischenberger JB. General surgical operative duration is associated with increased risk-adjusted infectious complication rates and length of hospital stay. J AmColl Surg 2010;210(1).60–65.e2
  2. Saleh K, Olson M, Resig S, Bershadsky B, Kuskowski M, et al. Predictors of wound infection in hip and knee joint replacement: results from a 20year surveillance program. JOrthop Res 2002;20(3):506–15.
  3. Lingard L, Espin S et al. Communication failures in the operating room: an observational classification of recurrent types and effects. Qual Saf Health Care.2004;13:330–334.
  4. Lim et al. Is the length of time in acute burns surgery associated with poorer outcomes? Burns 2014;40:235-240
  5. Sevdalis et al. Annoyances, Disruptions, and Interruptions in Surgery(DiSI).World J Surg(2008) 32:1643–1650

Biography:

ET 3 Plastic Surgery Trainee in Western Australia

About ANZBA

ANZBA is a not for profit organisation and the peak body for health professionals responsible for the care of the burn injured in Australia and New Zealand. ANZBA encourages higher standards of care through education, performance monitoring and research.

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