Perioperative Services - Caseview

Perioperative services developed a solution in-house to address the need for multiple disciplines to view surgical case information in real time. 

By Ho Lom Lee and Joyce Nacario, RN
The effective management of surgical operating rooms is crucial in ensuring safe, high quality and cost-effective patient care. However, such management can be very challenging due to the number of staff, patients and rooms involved, in addition to the necessary coordination of equipment, medications and supplies. To address this important issue, the UCSF operating room has developed a novel, easy-to-use tool to visualize and manage operating room use in real time. The purpose of this study was to examine cost effectiveness and efficiency levels resulting from the use of CaseView as a web-based resource to expedite patient care and cost-saving for an operating room in clinical practice. 
Resources collaborated to assess the needs of the teams that care for patients undergoing surgery. This spanned all areas from pre-op, through the operating room (OR) all the way to the patient floors that would eventually care for patients after surgery. 

Background

It takes a lot of coordination on the part of many individuals to effectively run an operating room. Surgeons, anesthesiologists, nurses and ancillary staff need to know anticipated case volumes, scheduled case times, complexity of cases, acuity of patients, staff availability with mixed skill levels, medications, supplies and equipment needed to deliver safe, high quality patient care.  As cases are added, rearranged and cancelled over the course of a day, providers and staff must have access to the latest information in order to plan their next actions.

Individuals outside the OR also have an interest in the status of surgical cases.  Staff at the surgical waiting area must provide updates to families of patients who are having surgery.  The clinics need to know the whereabouts of their surgeons. The Admitting department needs to verify that patients having surgery are properly admitted into the system.  Nurses in the units need to be able to anticipate when their patients are due back from surgery.

CaseView addresses these needs by providing a powerful yet intuitive visual interface to data that already exists in clinical databases, but which is otherwise difficult to obtain and interpret.  It allows interested individuals to make decisions based on the most up-to-date information, and promotes efficiency and situational awareness of what’s happening in the ORs.
When everyone is literally looking at the same display, decisions are made wisely and effectively with certainty.

Overview

  • A visual representation of past, present, future operating room cases at UCSF locations: Moffitt / Long, Mount Zion, Ambulatory Surgery Center
  • Real-time information – display is updated as cases progress; represented by a vertical line
  • Users identified using network account
  • Multiple views of cases
  • Hovering mouse over case displays information about case
  • Clicking on case opens popup window with more detailed information about case to enhance hand-offs including skin assessment, procedure names, drains, EBL, etc
  • Cost-saving and “green” for the environment by eliminating hundreds of daily paper print-out