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. 2019 Nov/Dec;34(6):561-568.
doi: 10.1177/1062860618821180. Epub 2019 Jan 17.

Decreasing Room Traffic in Orthopedic Surgery: A Quality Improvement Initiative

Alex C DiBartola  1 , Christine Barron  2 , Scott Smith  2 , Catherine Quatman-Yates  1 , Ajit M W Chaudhari  1 , Thomas J Scharschmidt  1   2 , Susan D Moffatt-Bruce  1   2 , Carmen E Quatman  1
Affiliations

Decreasing Room Traffic in Orthopedic Surgery: A Quality Improvement Initiative

Alex C DiBartola et al. Am J Med Qual. 2019 Nov/Dec.

Abstract

Operating room (OR) traffic and door openings increase potential for air contamination in the OR and create distractions for surgical teams. A multidisciplinary intervention was developed among OR staff, surgical staff, vendors, radiology, and anesthesia and approved by the hospital system's patient and quality safety department for implementation. Interventions included education, OR signage, and team-based accountability and behavioral interventions. After interventions were implemented, a second prospective, observational data collection was performed and compared to preintervention OR traffic. A total of 35 cases were observed over the 3-month period in the preintervention group; 42 cases were observed in the postintervention group. Average door openings per minute decreased by 22% (P = .0011) after intervention. All surgical groups excluding anesthesia had significant reductions in OR traffic following the intervention. Behavioral interventions that focus on education, awareness, and efficiency strategies can decrease overall OR traffic for orthopedic cases.

Keywords: hospital quality; interventions; operating room traffic; surgical site infections.

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Conflict of interest statement

Declaration of Conflicting Interests

The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Carmen E. Quatman and Laura S. Phieffer are con-sultants to Johnson & Johnson (New Brunswick, NJ, USA).

Figures

Figure 1.
Figure 1.
Bar chart indicating mean rate of door openings. Abbreviation: min, minute.
Figure 2.
Figure 2.
Shewart’s individual/moving-range control chart demonstrating the change in door openings over time. The gap in the time series demarcates the preintervention and postintervention cases. The downward shift post intervention indicates that a decrease in the rate of door openings was observed. The upward shifts in the postintervention time series indicate that although the rate was still lower than pre intervention, there was a steady increase in door openings as time progressed.
Figure 3.
Figure 3.
Shewart’s individual/moving-range control chart demonstrating the change in door openings over time. The gap in the time series demarcates the preintervention and postintervention cases. The downward shift post intervention indicates that a decrease in the rate of door openings was observed. The upward shifts in the post intervention time series indicate that although the rate was still lower than pre intervention, there was a steady increase in the door openings as time progressed.
Figure 4.
Figure 4.
Shewart’s individual/moving-range control chart demonstrating the change in door openings over time. The gap in the time series demarcates the preintervention and postintervention cases. The downward shift post intervention indicates that a decrease in the rate of door openings was observed, and this shift was maintained through the planned observation period.
Figure 5.
Figure 5.
Bar chart indicating team member role room traffic rates. Abbreviation: min, minute.
See this image and copyright information in PMC

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