Patients from emergency and inpatient units were transferred to the preoperative holding area with missing elements needed for surgery such as signed consents, required lab tests, full medical histories, and NPO status, thus causing surgical delays. This was a direct source of frustration for the patients and the surgical team.
In alignment with the Kaiser Permanente Nursing Professional Practice Model, the patient and family are at the center of this initiative. The objectives were to prevent delays in care, improve communication, empower nursing teams, optimize the surgical journey, and increase patient satisfaction. Using the PDSA model, the team created the Ticket to Ride (preoperative checklist) with a QR code.
The nurses from the ED and inpatient units can now scan the QR code to see the checklist of preoperative requirements adapted to individual procedures and patient situations. Baseline data in 2023 started at 5% completion of the preoperative checklist and by January 2024, preoperative checklists were completed 80% of the time. January through April 2024, increased up to 88% and has been sustained. In addition, secure chat, a messaging tool designed to allow users to communicate through a secure messaging channel has allowed for more efficient ED to OR times because it has decreased delays and reduced the amount of phone calls needed to convey pertinent information.
The project was lead by Sheri Berniklau, BSN, RN, CPAN, CAPA and Indie Mari, BSN, RN.
