R. C. Frazee1, A. Carnes1, Y. Munoz Maldonado1, T. Bittenbinder1, H. Papaconstantinou1 1Scott & White Healthcare,Departments Of Surgery And Anesthesia,Temple, Texas, USA
Introduction: First start delays in the operating room have a downstream effect on operating room efficiency and patient satisfaction. In accordance with the American Recovery and Reinvestment Act, in February 2014, our institution adopted EPIC ™ as our electronic medical record (EMR) system. The impact of the transition from paper to electronic documentation on operating room efficiency is not known. This study analyzed first start data as a measure of overall operative suite efficiency, looking at the initial impact and the learning curve to return to baseline parameters.
Methods: A retrospective review of on time start data was reviewed for three months prior and 4 months after implementation of the EMR. A start was considered delayed if the patient arrived to the room after the 7:30 start time. Patients transported from the intensive care unit were excluded from analysis. Data was analyzed using control charts for the percentages, and comparisons of the average percentage of on time starts before EPIC implementation against each month percentage using Dunnet’s method. Confidence intervals were calculated at 0.05 and 0.01 for significance.
Results: On time starts for the three months leading into EPIC implementation averaged 64.1%. After EPIC implementation, there was an initial drop in on time starts from to 41% (p<0.01). There was a gradual return to baseline levels over the ensuing 4 months.
Conclusions: Implementation of an EMR produced decreased efficiency in on time first starts in the operative suite, but the learning curve was brief, returning to baseline values in 4 months. These findings can serve as a guide for other institutions that are undergoing transition from a paper to an electronic medical record.
