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Session: Medical Instruments
Session starts: Thursday 24 January, 13:30
Presentation starts: 14:00
Room: Lecture room 557

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Linda Wauben (Delft University of Technology)
Annetje Guédon (Delft University of Technology)
John van den Dobbelsteen (Delft University of Technology)

Abstract:
Introduction: Each year 14,000 patients are treated at the six operating rooms (OR) of the Rotterdam Eye Hospital. Most patients are admitted in day-care. The total day-care surgical track involves many steps and many professionals. As the patient flow is mainly adapted to the OR-schedule and less adapted to e.g., ward staffing, the patient flow is disturbed, leading to long waiting times for patients and family. DORA (Digital Operating Room Assistant) supports staff with automatic and accurate information about the patient’s location in the surgical track. It reduces waiting times and improves patient and employee satisfaction. The objective of this study is to investigate surgical patient flows and improve these patient flows by implementing DORA. Methods: In a pilot study (8 days) observations and time recording of patient flows were performed. After the pilot RFID technology was installed and patients received a tag attached to their patient identification wristband. Patients were tracked for ten weeks. In both studies 31 moments were recorded (e.g., time entering/leaving hospital, time entering/leaving OR). Duration of actions and waiting times for patients at several stages were calculated. In addition, a DORA-user interface was designed, displaying the patient’s location in the surgical track and the anticipated time for moving to a next step. Results: During the pilot 222 adults were tracked. Analysed data showed that 157 patients (71%) arrived earlier then necessarily at the ward (average: 19min, STDEV: 15min, maximum: 1h14min), and 37 patients arrived late (average: 11min, STDEV: 13min, maximum: 1h8min). Patients spend an average of 5h38min in the hospital (STDEV: 1h47min, maximum 12h37min). At the Holding, patients had to wait an average of 22min (STDEV: 19min, maximum: 1h34min) between final preparations for surgery and transportation to OR. The response time of ward nurses to requests for picking up patients at the Recovery was 7min (STDEV: 8min, maximum: 1h8min). Twenty-four patients were picked up immediately after bringing another patient to the Holding. Data obtained via the RFID tags is now analysed and will be presented at the conference. Also the design for the DORA-user interface will be presented. Discussion: The results show that the waiting times make up a considerable part of the duration of the entire surgical track and show that the waiting times are highly variable. RFID technology and the DORA-user interface automatically track the patients. It provides the professionals with ‘real time’ information about the patient’s location and the anticipated time for e.g., leaving the ward, start of surgery. It can also improve patient scheduling, patient satisfaction and the efficiency of patient transport.