Transcript The Cost Effectiveness and Efficiency of Using a CaseView

Kaz Sobczak1, Joyce Nacario2 , Ho Lom Lee3
1University of California Medical Center, San Francisco, CA (USA)
2University of California Medical Center, San Francisco, CA (USA)
3University of California Medical Center, San Francisco, CA (USA)
[email protected], [email protected],
[email protected]
Purpose and Background
 UCSF operating room has developed a novel, easy-to-
use tool to visualize and manage operating room use in
real time called CaseView.
 CaseView was built specifically as an information tool for
medical, administrative, and perioperative staff.
 The purpose of this study was to examine cost
effectiveness and efficiency levels resulting from
using CaseView as a web-based technology to expedite
patient care and cost-saving for an operating room in
clinical practice.
CaseView as a Web-Based Resource Technology
 Joyce Nacario-a nursing informatics expert and clinical nurse IV at
UCSF Medical Center Operating Room, helped design and run a
web-based resource called CaseView with the cooperation of Ho
Lom Lee, a programmer, and Dr Kulli, a perioperative medical
director [3].
 CaseView was developed using existing computer infrastructure,
Microsoft Net, information processes, and information
technology.
 CaseView provides dynamic and sophisticated information,
using text, still images, video, audio files, and various web
design techniques without incurring any external costs.
 Using internal resources, CaseView is supported by one
informatics nurse and one programmer
CaseView Feature
 The
data elements used to build the
CaseView display include:
•
•
•
•
•
Room (OR) number
Surgeon name
Name of anesthesiologist
Name of surgical procedure
Patient name
•
•
Scheduled case start time
Scheduled case duration
Actual case start time
•
Actual case duration
•
Real-time information
The operating room and PACU display are shown below.
 The color purple indicates that the patient has arrived at the surgical waiting area.
 Green indicates that the patient is in the preop area.
 Blue indicates that the patient is in the OR and pink is used to record that the
patient is in PACU.
 Yellow indicates that the patient is still going to the OR (pending cases).
Start and End Times: Turnover Times
Cases completed, underway, and upcoming are all shown on the same screen.
 Completed cases are depicted using actual start and end times.
 Case start and end times are displayed down to the minute, not in 15 or 30 minute
increments.
CaseView Supplies
.
 CaseView tracks all supplies used in the operating room at UCSF Medical Center Hospital.
 It is now being applied to map out a cost-effective approach to supply usage.
This report summarizes the application designed to specific procedures
Setting and Methodology
 The test of CaseView was conducted in the operating room unit of an
academic medical center, UCSF.
 The study took place from February 2010 to June 2010.
 All operating room staff members were invited by email to participate in a
web-based survey asking them to evaluate how CaseView affected the
health care team's efficiency, knowledge, retention, team building,
leadership skills, professional development, knowledge management,
evidence-based practice, and, most importantly, patient safety.
 The convenience sample (N = 119) was selected from an academic
medical center, UCSF over a 3-month period and consisted of surgical
staff using CaseView.
 The survey included open-ended and closed-ended questions,
multiple choice questions, matrix questions, as well as
dichotomous yes/no questions, with “yes” signifying positive and
“no” negative effects.
Results
 Over 90% of the respondents said that CaseView expedited patient care and costsaving clinical practice.
 It was also described as environmentally friendly, as it eliminates the need to print out
hundreds of pages of paperwork daily.
Quick &
easy to
use
Real time
data
Good
Average
71.0%
25.0%
(25)
3.0%
0.0%
(3)
(0)
4.0%
1.0%
(4)
(1)
4.0%
0.0%
(4)
(0)
5.0%
1.0%
(5)
(1)
4.3%
0.0%
(4)
(0)
(71)
67.7%
(67)
71.0%
Informative
Increases
efficiency
Below
Excellent
(71)
69.0%
(69)
27.3%
(27)
25.0%
(25)
25.0%
(25)
Average
Rating
Response
Average
Count
4.65
100
0.0%
(0)
4.62
99
0.0%
(0)
4.67
100
0.0%
(0)
4.62
100
0.0%
(0)
4.64
92
Poor
1.0%
(1)
Enables
situational
awareness
68.5%
(63)
27.2%
(27)
Conclusions
 CaseView web-based technology addresses health care providers’
needs for better time management and improved cost-effectiveness
by providing a powerful yet intuitive visual interface to data that already
exist in clinical databases.
 It allows stakeholders to make decisions based on the most up-to-date
information and promotes efficiency as well as situational awareness
regarding the OR.
 Results of the survey show that without CaseView, monitoring data and
recording the business of providing health care would be inefficient and
would further strain the hospital’s resources.
 The current pace of change in health care knowledge and information
technology continues to accelerate.
 CaseView offers tools for health care providers to manage this
exponential increase in information technology so that the most
cost-effective treatment decisions can be made that will result in
the optimal outcomes for patients.