The goal of this improvement project was to increase the proportion of patient anesthesia screens conducted by NPs to 50% within 6months. Methods After discussion with key stakeholders of the process, a multidisciplinary improvement team identified a set of operational factors

(key drivers) believed to be important to the success of the preoperative anesthesia screening process. These included the development of dedicated NP time for daily screening, NP competency and confidence with the screening process, effective mentoring by anesthesiologists, standardization of screening process, and communication with stakeholders of the process, that is, surgeons. These key drivers focused on the development of several interventions such as (i) NP education in the preoperative anesthesia screening for consultation process by a series of didactic lectures conducted by anesthesiologists, and NP’s shadowing an anesthesiologist click here during the screening process, (ii) Anesthesiologist mentoring and assessment of NP screenings using the dual screening process whereby both anesthesiologists and NP conducted the screening process independently and results were compared

and discussed, (iii) Examination and re-adjustment of NP schedules to YH25448 price provide time for daily screening while preserving other responsibilities, and (iv) Standardization through the development of guidelines for the preoperative screening process. Measures recorded included the percentage of patient anesthesia screens conducted by NP, the percentage of dual screens with MD and NP agreement regarding the screening decision, and the average times taken for the anesthesiologist

FK228 purchase and NP screening process. Results After implementation of these interventions, the percentage of successful NP-assisted anesthesia consultation screenings increased from 0% to 65% over a period of 6months. The Anesthesiologists’ time redirected to non-OR anesthesia averaged at least 8h a week. The percentage of dual screens with agreement on the screening decision was 96% (goal >95%). The overall average time taken for a NP screen was 8.2min vs 4.5min for an anesthesiologist screen. The overall average operating room delays and cancelations for cases on the day of surgery remained the same. Conclusions By applying quality improvement methods, we identified key drivers for the institution of an NP-assisted preoperative screening process and successfully implemented this process while redirecting anesthesiologists’ time for the provision of non-OR anesthesia. This project was instrumental in improving the matching of provider skills with clinical need while maintaining superior outcomes at the lowest possible cost.”
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