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STP in Pediatric Neuroanesthesia

STP in Pediatric Neuroanesthesia. Feaster, Sun, Seybold, & Chen. Situation. Turnover Time is too long and variable. Preliminary data seems to support it. Average TAT (wheels out-wheels in) neuro core group: 41 min non- neuro group: 72 min.

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STP in Pediatric Neuroanesthesia

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  1. STP in Pediatric Neuroanesthesia Feaster, Sun, Seybold, & Chen

  2. Situation • Turnover Time is too long and variable. • Preliminary data seems to support it.

  3. Average TAT (wheels out-wheels in) neuro core group: 41 min non-neuro group: 72 min

  4. Turnover time is multi-factorial Better processes: Valuestream, RPI, etc Low hanging fruit available Results from creation of “neuro core” group • standardize work flow • more surgeon satisfaction • fewer incidents • faster turnover

  5. Target • Increase efficiency (w/o decreasing quality) • Do two crani’s per day without staying until mn. • Improve patientsatisfaction • Improve surgeon satisfaction • Improve anesthesia satisfaction (also increase safety as by-product)

  6. Proposal • Utilize non-licensed personnel • Standardized call for assistance during line placement (20/20/20 rule) • Collect more Turnover data to determine delays • Write up standardize work flow • Fellow elective/concentration in Neuroanes

  7. Action Plan: May • Collecting Data Mine Cerner for turnover data Keep weekly Log of delays (sx, equip, anes) Weekly tally to spot trends Immediate follow up of unusual issues • Who: Feaster, Chen, & Claure

  8. Action Plan: June • Anes tech training process. Define expectation of anes tech Use videos and simulation exercises • Who: Mireles, Chen, and Nursing

  9. Action Plan: July • Create neuroanes elective/concentration for fellows. Define elective objectives and expectations Work out logistics rotation Finalize standard work write ups • Who: Wagner, Seybold, & Furukawa

  10. Action Plan: Future • Standardization of work flow (PPI, remi, lines, eye tape) • Amicar and Tranexamic Acid for craniosynostosis • Create TIVA protocol for post-fossa (dex? clonidine?) • Training and maintenance of skill for subclavian lines (video) • Improve safety and efficiency in IR • Post-op surveillance for post-op complications (delirium, OIH, hypertension, delay wakening, etc) • Case review and journal club • Neuroanes lecture series • Initiate research projects • Become a national leader in pedsneuroanes • Who: Everyone

  11. the end

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