Preintervention (n=20) | Postintervention (n=20) | |||||
Total process steps: mean 24, range 13–40 | Total process steps: mean 13, range 13–13 | |||||
Common process steps | Time | Protocol process steps | Time | P value | ||
1 | Walk to get protocol | 00:00:38 | 1 | Walk to presurgical area core | 00:00:25 | |
2 | Retrieve protocol | 00:01:18 | 2 | Collect kit in pre-surgical core | 00:00:07 | |
3 | Walk and retrieve dexmedetomidine | 00:00:49 | 3 | Collect lidocaine | 00:00:15 | |
4 | Walk to get presurgical area equipment and medications | 00:03:05 | 4 | Walk to operating room core | 00:00:29 | |
5 | Collect presurgical area equipment and medications | 00:01:06 | 5 | Collect infusion pump | 00:00:15 | |
6 | Setup presurgical area equipment | 00:05:53 | 6 | Walk to airway storage area | 00:00:20 | |
7 | Walk to get operating room equipment and medications | 00:02:37 | 7 | Collect fibreoptic tower | 00:00:09 | |
8 | Collect operating room equipment and medications | 00:00:38 | 8 | Walk to operating room | 00:00:31 | |
9 | Set up operating room equipment and medications | 00:07:20 | 9 | Set up equipment | 00:05:22 | |
10 | Walk to operating room pharmacy | 00:00:16 | ||||
11 | Collect dexmedetomidine | 00:00:04 | ||||
12 | Walk to operating room | 00:00:18 | ||||
13 | Set up dexmedetomidine infusion | 00:02:27 | ||||
Mean setup time | 23.4±6.2 min | Mean setup time | 11.0±2.1 min | <0.001 | ||
Mean non-value added time | 10.2±3.6 min | Mean non-value added time | 3.2±0.6 min | <0.001 | ||
Mean value added-time | 13.2±4.0 min | Mean value added-time | 7.8±2.0 min | <0.001 |
Many different process steps were observed in the preintervention simulations. Nine common process steps were identified from an overall average of 24 process steps and used to summarise the data. The process steps in the postintervention simulations correlated to the technician instruction sheet. Non-value added time encompassed walking and collecting equipment whereas value added time involved setting up equipment