Anticlue

Decision Criteria Matrix

We opened up the inherited hospital a couple of weeks ago. Given the scale of the endeavor, it went swimmingly well. A lot of hardwork by good people came together.

Now we are finding the gaps in the processes. One item has arisen around OR Communications. As a part of care in the OR, the team has to be fluid and able to reach out across the team. When situations occur, the ability to react in a quick and deliberate manner is key. Communications via many mechanism are necessary.

In walking through the area, it was obvious communications would be difficult. The nurse call system wasn't setup to flow with the workflow of the OR. Some pull cords were outside of the OR rooms, others were in the room, but didn't have the speaker. In the department no one knew the zones of the overhead paging system, and obviously you don't want to call the code team to the OR. Especially when the OR has a team available if you could just get the team.

So rightfully, the director of the OR escalated the sense of urgency, due to the impact a lack of functionality is having in her department. Wireless wasn't up yet, most of the equipment in the PACU are laptops. The application wasn't working with the new workflow. It was hard to reach out to other team members, because of a lack of ability to communicate.

In response, we did walk-thru of the OR with the tech gurus. So everyone could understand the impasse and come up with solutions to the communication problem. I have to say, I am proud of the team. The solutions were varied from some needing capital approval, voicera and repeaters for cell coverage, to expanding on existing solutions.

In order to give the decision makers, adequate information, we derived a matrix to cross compare. Our decisions were evaluated against:

• High Level Scope of Work: We captured this data, because the group had three scopes: the or, the or, obs, and or inventory, and across the house.
• Possible Solution: The details of the proposed solution
• Duration: The rough order of magnitude estimate to the time to implement the solution
• Funding: Whether this was a funded in flight project, or if this needed funding
• Technical Feasibility
• Financial Feasibility
• Operational Feasibility

All in all, it is a good tactic. The decision makers have the necessary information to make the best decision for the health system. Now we just have to walk through that process for the long term solution.

In the short term, we all agreed getting the manual fall back overhead zones was essential to patient safety. We had that solution in place and working by the end of the week.