It is hard to explain how everything goes to someone who is not familiar with an operating room. You could compare it to a busy crossroads in the Anspachlaan in Brussels. While you are rushing to get to the other side, there are many things happening around you which might affect your crossing:
A traffic light that is broken, a driver who is not paying attention, a nervous police officer, two children who are playing hopscotch on the pedestrian crossing, tourists who want to take a picture in the middle of the road, a stray dog, an ambulance with flashing lights that is making a lot of noise or a shoelace that is undone and that makes you trip …
Of course these are all metaphors. In an OR there are not police officers or traffic lights, let alone a stray dog. I just want to show that it is our job to transfer the patient to the other side of the road in a safe way, whereas there are a whole number of factors that may have an influence on the process. We have to be able to cope with these factors for the benefit of the patient.
Everyone in the OR has the responsibility to properly deal with these factors. I am primarily talking about the physician, the nurse and the central sterilisation department. But next to these there are still some other players that work behind the scene: the nurse ward, the purchasing department, the technical service, the IT, the admission service, the logistics team, the maintenance team. Every chain in the process needs to be closed, otherwise a wheel might fall off – something which we absolutely want to avoid: no unnecessary fuss or chaos, but calmness. Calmness for the patient and for the environment that we need to work in.
In order to maintain an overview of the whole process we have been using a practical tool since September: E.care. This is a computer programme that offers an overview of all the chains in the process. It allows us to follow up on the patient in the whole trajectory.
You could compare it to the way in which a radar at an airport works. On the screen you can see all the planes, their exact location, where they have to go, their speed etc.
To us, E.care is this radar. It tells us where the patient is and in which phase of the process he or she is in. But the programme can do more than just show us where the patient is. It allows us to make a correct planning, to get an overview on the required and consumed materials, to process invoicing data, to follow up on pre-operative screening, to deduct specific statistics, to establish links to other programmes … The only thing that it cannot do is warn us if our shoelaces are undone.
E.care can do a lot, but it is and will always be a computer programme offering support in the care process. In the end it is the actors in the hospital that have to make an effort for the good care of the patient.
The implementation in our hospital went quite smoothly thanks to the fact that everyone getting into contact with the programme really made an effort to get to know it.
From the doctors we expected an input as to the correct description of their intervention, the nurses mainly had to link the materials to these interventions, the secretariats had to learn how to work with the programme in the short term, for the ward the programme meant ‘another’ informatics package and the IT department was to make sure that everything ran smoothly. We succeeded in all of this.
I am still surprised that everybody was so willing to contribute to this process, and I would like to seize the opportunity to thank all of the people once again.
But it does not stop here.
E.care is a house. The foundations have been cast and we can start building. We can make the house as big as we want – a traditional terrace house or a luxurious villa. We receive tips from the secretariats on how to make things easier for them, the nurses on the shop floor are making an effort to use all the applications correctly, the physicians are asking for a different planning of their OR time, the anaesthetics ward wants to have a better pre-operative trajectory … All of these are things that we will be using for the construction of our home. However, we promise to keep our feet on the ground. We do not want to build a castle in the air.
We want the system to be a useful tool for everybody.
Chief nurse of the operating room
AZ St. Jan Campus Serruys