Search
Go Back

Dec. 13 Procedural Capacity Incident Command update

15 Dec 2024

By: Incident Commanders Matt Boles, MD; Leah Mitchell and James Parr

The Incident Command team has continued its complex work this week to ensure our patients receive surgical care at the clinically indicated time, 100% of the time. This is part of what sets Salem Health apart: a willingness to spend the time, energy and resources to tackle complex problems, recognizing that things could be better for our patients. Healthcare has a tendency to calcify systems that are problematic, but “good enough.” Changing this dynamic requires a unique culture that is willing to work across areas of responsibility, be open minded and relentlessly embrace the basic tenants of data-driven problem solving. We are very proud of a culture that makes this kind of difficult but very valuable work possible. 

Key successes this week include: 

  • In an effort to create additional surgical add-on capacity, the team has been testing the movement of a surgical robot from Building A to Building C. A team of users including surgeons successfully simulated procedures in the new location. Some small room upgrades are now underway to facilitate the transition, which should be completed early next year
  • The team simulated new protocols to create more block time that would be available on a first come, first serve basis. The new approach could increase block time. The team will solicit additional feedback from impacted stakeholders in the next few weeks before the new approach is implemented.
  • We continue to work within Sterile Processing Department to ensure we can meet current and future volumes. This includes an updated inventory system, additional support from instrumentation vendor, new processes to address safety and quality, updating standards for training and escalation, and prioritization of instrument repairs. 
  • The team continues to deploy and refine numerous tests of change to increase the flow of patients through surgical clinics, including work around staffing gaps and improved decision trees. 
  • The team has deployed new ways of increasing anesthesiology availability after primetime. 

The incident command structure will pause over the next few weeks while a group of key stakeholders (surgeons, anesthesiologists, clinic leadership, ancillary services) monitor patient flow to assess impact of recent work. After this period of assessment, we will deploy another incident command for the next period of improvement efforts. 

Big thank you to all of the staff and providers who have put their time and energy into this work. Dr. Leander Moncur, who has been an instrumental leader in this process, had this to say about this week’s efforts: "This is complicated work, but I'm proud of how we've maintained focus on our mission through challenging problem solving. My goal is a vibrant and thriving anesthesiology group that can provide our patients with the best care. When we are transparent with all team members about problems, we can find shared goals and solutions."

Thank you to all who have given their time and energy to these efforts. This is not easy work, but care in our community is better because of it.