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Thank you for attending THSNA 2026. The virtual meeting is now closed.
Thank you for attending THSNA 2026. The virtual meeting is now closed.
Presentation Details
| Increasing the Timeliness of Surgery PlanDocumentation for Patients with Bleeding Disorder-A Quality Improvement Project (THSNA �Travel Awardee) Amber Pruett1, Vilmarie Rodriguez1, 2, Charmaine Biega1, Michelle Hallam1, Courtney Kirby1, Olivia LaHote1, Sarah H O'Brien1, 2, Lynda Villa-Gomez1, 2, Amy L.Dunn1, 2. 1Nationwide Children's Hospital Division of Pediatric Hematology, Oncology, Bone Marrow Transplant and Apheresis, Columbus, OH, USA.2The Ohio State University College of Medicine, Columbus, OH, USA |
Abstract
Increasing the Timeliness of Surgery Plan Documentation for Patients with Bleeding Disorders - A Quality Improvement Project Background Patients with bleeding disorders require timely, well-coordinated surgical planning to minimize perioperative risks. At baseline, only 35.97% of surgery plans were completed at least seven days before the scheduled procedure. Late plan completion created safety concerns, inconsistent preparation, and communication gaps between surgical, hematology, and pre-admission testing (PAT) teams. Objectives To increase the percentage of surgery plans completed at least one week prior to surgery from 35.97% to 80% by August 31, 2025, and sustain this level for six months. This target supports the broader institutional goal of improving patient safety. Methods A quality improvement approach was employed using a key driver diagram to identify essential contributors, including standardized processes, clear provider roles, adequate lead times, effective cross-department communication, and understanding of patient needs. Interventions included: Development of a standardized note template within the electronic health record (EHR) Creation of a surgery plan checklist Development of standard operating procedures (SOPs) defining provider responsibilities Guidance regarding requirements for pre-plan clinical visits Improved communication processes between the Pre Admission Testing team (PAT) and the hematology team Department-wide education on surgery plan requirements and timelines Coordination with surgeons and PAT to request surgery plans at the time of scheduling Performance was measured using a p-chart to track the percentage of plans completed ≥7 days before surgery. Results Baseline data collected through March 2024 showed a baseline stage mean of approximately 35.97%, consistent with historical performance. After early interventions—including the creation of documentation standards within the EHR and improved communication between PAT and hematology—the process stage mean increased to approximately 51% by April 2024. From April 2024 through early 2025, monthly performance demonstrated sustained improvement with several months above the 80% goal. Templated documentation markedly improved workflow standardization and reduced documentation variability. Although some fluctuations remain, performance continues to trend upward towards the goal; however, future data is needed to confirm the sustainability of the 80% target. Conclusions This quality improvement project significantly improved the timeliness of surgery plan completion for patients with bleeding disorders. Key interventions—including standardizing documentation, enhancing communication pathways, and clarifying team roles—led to an increase in the process mean from 26% to 51%. Most recent data demonstrate that we have approached or exceeded the 80% target threshold. Continued implementation of remaining interventions, along with sustained monitoring, will be essential for achieving and maintaining these metrics.
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No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author.