Ask the Expert: New Ways to Find Time for More Surgeries

According to a recent Canadian Institute Health Information (CIHI) update, the number of surgeries completed in Canada has rebounded to pre-pandemic levels, or 5% more than 2019–2020*. Still, surgical backlogs continue to ail the system and vary from province to province. Some provinces are in worse shape than others, such as in Manitoba where surgery volume is still 40% behind pre-pandemic levels.

While hospitals continue to increase the number of surgeries they perform and work to reduce wait times, opportunities exist for hospitals to work with their partners to find new ways of creating efficiencies, or time-savings, that can be reallocated to help increase surgical volumes.

In this Ask the Expert, we speak with Luc Drisdelle RN, BN, MN and Acute Care Clinical Specialist, about the potential role that suppliers can play in delivering efficiency, cost-savings and value. He also explains how Medline’s Complete Delivery System (CDS) helps simplify supply management with methodologies that link people, processes and supplies with time and cost savings.

Q: What are the current challenges affecting operating room efficiency across Canadian hospitals? How do these challenges contribute to the growing surgical backlog?

Current challenges affecting operating room efficiency across Canadian hospitals are numerous and vary in their complexity, including lack of specialized staff (surgeons, nurses, etc.), new nursing staff, poor communication, lack of MDRD staff, advances in surgical procedures and equipment, inefficient custom packs, long turnover times and inefficient supply chain practices. These factors contribute to surgical backlogs in our healthcare system.

Q: Can you walk us through the different supply options currently being used in operating rooms (OR) and how they impact OR efficiency, such as single sterile packs, generic standard packs, custom packs and Medline’s Complete Delivery System?

We know there are variations of surgeries being done, as well as different supplies required for those surgeries. Currently in Canada, several supply options exist to perform surgeries, and all of these have impacts on OR efficiency. These could include:

• Single sterile items – every item is wrapped and opened individually (requiring more time for set up).
• Generic standard drape packs – a grouping of surgical drapes wrapped in a table cover and every other item is opened individually.
• Generic procedure packs – a variety of components, such as surgical drapes, needle counters, sponges and cautery, are wrapped in a table cover that are mass produced but cannot be modified to the specific customer needs.
• Custom Packs – customer-specific packs include the components and drapes customers selected for use in specific procedures.
• Complete Delivery System (CDS) – includes specific sterile custom pack and non-sterile sub-assemblies for anesthesia (syringes, ECG leads, O2 saturation, etc.), circulating nurse (final dressing supplies, foley catheter, drainage bag, cautery pad, etc.) and turnover supplies (mop head, wiping cloths, garbage bags, surgical table linen, suction cannisters, etc.).

Q: Why should hospitals consider switching to custom packs instead of continuing with single sterile items or generic packs?

With long surgical wait-times continuing across Canada, ORs can improve efficiency to reduce wasted downtime and potentially execute more daily surgeries. To reduce downtime, custom supply packs can improve surgical set up time by reducing how many single items need to be opened (each item can take about 5 seconds to open) and by reducing the pick time for surgery carts, which are assembled for the operating room. Time saved can allow for more procedures to be performed.

Q: What is a utilization review, and why is it important for optimizing OR performance? What are the key benefits of conducting a utilization review, and what critical information should be examined during this process?

A utilization review is performed by site clinical staff (service leads/theatre staff) who evaluate current packs for optimum usage and the performance of each component related to waste reduction, increased efficiencies, shortened set-up time and staff satisfaction. Constant technological advancements, new staff and new surgeons, with differences in approaches or techniques, can impact the contents of custom packs. Reviews can also determine if current packs are still required, or if a new pack is warranted based on the site’s surgical volume data. In collaboration with the Medline clinical team, reviews are based on the site’s surgical volume data – it’s a data driven process.

Q: From your experience, what role does collaboration between clinical experts and local clinical staff play in improving surgical pack optimization?

In my experience, it’s important that clinical experts and local clinical staff have open communication throughout the process. The clinical expert, based on their analysis of the site’s surgical volume data, will make suggestions or modifications to help create efficiencies. These suggestions can be accepted or rejected based on the site’s needs or practices. The clinical expert is a partner and wants to help sites achieve efficiencies in their surgical programs.

Q: How can hospitals evaluate the impact of the Complete Delivery System on their surgical processes and patient outcomes?

Impact evaluation of a Complete Delivery System is multi-faceted. With the help of the Medline staff, the hospital can assess benefits through surgery cart assembly process improvements, cost-savings, increased productivity, space utilization, standardization, less on-hand inventory and shorter room turnover time. These improvements help reallocate time to patient care and contribute to better patient outcomes.

Q: How can hospitals learn more about Medline’s Complete Delivery System?

Hospitals can learn more about Medline’s Complete Delivery System by contacting their local Sales Account Manager or Acute Care Sales Specialist. Visit Medline.ca for information on Medline’s Perioperative Solutions.

*Taking the Pulse 2024, Canadian Institute of Health Information (CIHI), October 2024.