Posters 11: EDI, Covid & Patient Relations

Sunday June 26, 2022 from 07:30 to 09:00

Room: Souris

MP-11.5 Quality improvement of surgical team communication of required percutaneous nephrolithotomy equipment

Abstract

Quality improvement of surgical team communication of required percutaneous nephrolithotomy equipment

Mark Assmus1, Matt Lee1, Jessica Helon1, Amy Krambeck1.

1Department of Urology, Northwestern University, Chicago, IL, United States

Introduction: Percutaneous nephrolithotomy (PCNL) allows for a range of instruments within the urologist’s armamentarium. Case-to-case variation creates challenges within the operating room. Appropriate communication can help ensure safe, efficient, and cost-effective patient care. The goal of our study was to first perform a quality assessment of equipment communication. Second, we identified and assessed a target intervention to improve communication and surgical case cost. 

Methods: We administered 45 prospective (30 baseline, 15 post-intervention) questionnaires to multidisciplinary endourology members involved in ≥3 PCNL cases between August 1, 2021, and October 30, 2021. The primary objective was postoperative perception of communication regarding equipment (Likert scale: 1-poor, 10-perfect). A real-time, editable equipment whiteboard was designed and implemented with post-intervention provider surveys. The relative difference in pre- and post-intervention equipment accuracy, as well as overall case costing, was compared 30 days prior to implementation to the period after the intervention. Comparisons used Fisher's exact test (p<0.05). 

Results: Baseline surveys (n=30) were completed (15 registered nurses, eight resident physicians, five surgical techs, two fellows) with an average 2.6 years (range <1–7 years) of PCNL experience. Pre- and postoperative assessment of communication improved after implementation of the whiteboard (preoperative: 6.7 vs. 8.9, p<0.001; postoperative: 7.0 vs. 9.3, p<0.001). On average, 3.2 items (range 2–5) out of five items were accurate on pre-intervention cases. Post-intervention accuracy improved to 4.4 (3–5)/5 items (p=0.049). There was a significant relative case cost improvement after implementing the whiteboard, with an average of $292.50 USD savings per case (p=0.045).    

Conclusions: The development of a real-time, editable PCNL equipment whiteboard improved team perception of equipment communication, case item accuracy, and provided a relatively average cost saving for PCNL at our center.



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