Hospital operating rooms have been identified as critical sources of surgical site infections (SSIs) and, therefore, extremely sensitive in the facility. Surgical procedures expose patients to operating room microorganisms transmitted from surgical equipment, healthcare workers, air and patients’ own surgical sites. Notwithstanding, notable developments have been witnessed in surgical procedures and infection control strategies, patients still experience surgical site infections in operating rooms.
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Outcomes of these infections are noted on the quality of care, including increased mortality and morbidity, extended lengths of hospital stays and costs of care. While deaths are involved in some cases, costs can be significantly high. Consequently, the Medicare, for instance, no longer caters for costs associated with SSIs. Thus, patients bear such financial burdens.
On this note, innovative change models are necessary to mitigate adverse outcomes at operating rooms because of surgical site infections.
Innovative Change Model for Operating Room
The innovative model for change identified for the operating room is user-driven innovation. The user-driven innovation puts much emphasis on “the user to adapt and customize products, including devices, processes, and outcomes” (Blakeney, Carleton, McCarthy, & Coakley, 2009, p. 1). The most important aspect of the model is that it highlights the relevance and abilities of end users to adapt and design products while sharing their knowledge to meet the identified needs. Blakeney et al. (2009) noted that nurses have often used user-driven innovation model when they need to change policies, procedures, devices and certain situations to account for immediate or specific needs of patients.
By adopting this model, nurses can create innovative processes and procedures for operating rooms as long as they possess the required skills and expertise to customize specific processes, practices, guidelines and procedures. Nurses must work collaboratively with others as they share ideas to improve operating room procedures. Sharing of ideas is necessary to ensure that nurses can leverage and combine diverse efforts to develop innovative solutions. Nurses can achieve this through cooperation and networks, which would enhance the turnaround time and effectiveness of the proposed innovative solutions.
For instance, user-driven innovation model can be applied to enhance operating room safety and efficiency by optimizing procedures (Smallman & Dexter, 2010). Various researchers have focused on evaluating different approaches to enhance operating room safety and efficiency, curtail costs and ensure high quality surgical services (Friedman, Sokal, Chang, & Berger, 2006). Innovative changes for improving safety and efficiency in operating room focus on streamlining the current procedures and processes applied in patient management during preoperative, intraoperative and postoperative care. Specifically, innovative changes have focused on operating room ergonomics, schedules, minimizing delays noted and identifying potential procedures that could have meaningful, positive impacts on efficiency and safety during surgical procedures.
Formal training of nurses and other care providers in operating room is necessary. The training would ensure that they develop a team approach to delivery services (Hurlbert & Garrett, 2009). Effective training minimizes hierarchies that slow efficiency and safety in operating. For instance, nurses can work together with physicians and question some of their procedures without fear. Nurses also require preoperative briefings to strengthen operating room procedures. It is necessary that such training should be regular to enhance culture change and participation of many nurses and physicians.
As noted previously, the model focuses on the role of the user to promote change. Therefore, continual and regular reinforcement of the learned concepts by considering human factors is also necessary (Dexter, Dexter, Masursky, Garver, & Nussmeier, 2009). The operating room should have a physician mentor to guide preoperative briefing procedures. The mentor must stay in the operating room to ensure and remind nurses and physicians that briefings are necessary and assist in identifying the fundamental safety and efficient processes. It is necessary for a surgeon to lead to the team because of expertise to improve effectiveness.
Nurses may also need periodic operating room training sessions from external speakers to reinforce learning and emphasize the relevance of briefings in improving safety and efficiency in the operating room. External speakers would bring new concepts, best practices and management of briefings from other facilities.
Finally, it is also necessary for operating room staff to collect data to determine outcomes of innovative change model for enhancing efficiency and safety. The evaluation should account for all processes involved in improving the procedures for preoperative, intraoperative and postoperative. The outcomes can demonstrate the real effects of change in the operating room.
The most important aspect of the user-driven innovation model is the focus on nurses and physicians. They must function as a coherent team to improve safety and efficiency, reduce time for room turnover, review scheduling and other critical management practices (Sulecki, Dexter, Zura, Saager, & Epstein, 2012).
As physicians, nurses and other care providers struggle to reduce surgical sites infections, reduce adverse outcomes and enhance safety and efficiency in operating rooms, they can adopt the user-driven innovation model to change procedures and processes to achieve the intended goals. While several changes and improvements have been noted in operating rooms, physicians and nurses can use the standard framework, but adapt the given procedures to meet the needs of their unique facilities and patients. It is believed that the user-driven innovation model can lead to improved safety and efficiency in the operating room.
Blakeney, B. A., Carleton, P. F., McCarthy, C., & Coakley, E. (2009). Unlocking the Power of Innovation. OJIN: The Online Journal of Issues in Nursing, 14(2), Manuscript 1. Web.
Dexter, E., Dexter, F., Masursky, D., Garver, M. P., & Nussmeier, N. A. (2009). Both bias and lack of knowledge influence organizational focus on first case of the day starts. Anesthesia & Analgesia, 108(4), 1257-61. Web.
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Friedman, D. M., Sokal, S. M., Chang, Y., & Berger, D. L. (2006). Increasing Operating Room Efficiency Through Parallel Processing. Annals of Surgery, 243(1), 10–14. Web.
Hurlbert, S. N., & Garrett, J. (2009). Improving operating room safety. Patient Safety in Surgery, 3, 25. Web.
Smallman, B., & Dexter, F. (2010). Optimizing the arrival, waiting, and NPO times of children on the day of pediatric endoscopy procedures. Anesthesia & Analgesia, 110(3), 879-87. Web.
Sulecki, L., Dexter, F., Zura, A., Saager, L., & Epstein, R. H. (2012). Lack of value of scheduling processes to move cases from a heavily used main campus to other facilities within a health care system. Anesthesia & Analgesia, 115(2), 395-401. Web.