Managing bottlenecks in the perioperative setting: Optimizing patient care and reducing costs

Maks Mihalj; Andrea Corona; Lukas Andereggen; Richard D Urman; Markus M Luedi; Corina Bello

doi:10.1016/j.bpa.2022.05.005

Managing bottlenecks in the perioperative setting: Optimizing patient care and reducing costs

Best Pract Res Clin Anaesthesiol. 2022 Aug;36(2):299-310. doi: 10.1016/j.bpa.2022.05.005. Epub 2022 Jun 3.

Authors

Maks Mihalj¹, Andrea Corona², Lukas Andereggen³, Richard D Urman⁴, Markus M Luedi⁵, Corina Bello⁶

Affiliations

¹ Department of Cardiovascular Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Electronic address: maks.mihalj@insel.ch.
² Department of Intensive Care Medicine, Cantonal Hospital of Graubuenden, Chur, Switzerland. Electronic address: crowna88@gmail.com.
³ Department of Neurosurgery, Kantonsspital Aarau, Aarau, Switzerland. Electronic address: lukas.andereggen@ksa.ch.
⁴ Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA, USA. Electronic address: rurman@bwh.harvard.edu.
⁵ Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Electronic address: markus.luedi2@insel.ch.
⁶ Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Department of Anaesthesiology, Spital Grabs, Spitalregion Rheintal Werdenberg Sarganserland, Grabs, Switzerland. Electronic address: corina.bello@bluewin.ch.

PMID: 36116911
DOI: 10.1016/j.bpa.2022.05.005

Abstract

Bottlenecks limit the maximum output of a system and indicate operational congestion points in process management. Bottlenecks also affect perioperative care and include dimensions such as infrastructure, architectural design and limitations, inefficient equipment and material supply chains, communication-related limitations on the flow of information, and patient- or staff-related factors. Improvement of workflow is, therefore, becoming a priority in most healthcare settings. We provide an overview of bottleneck management in the perioperative setting and introduce dimensions, including aligned strategic decision-making, tactical planning, and operational adjustments.

Keywords: culture; operating room management; outcome; quality; safety.

Publication types

Review

MeSH terms

Humans
Perioperative Care*
Workflow