The Efficiency of Dr. Booth's Surgery Procedure.

Question 1: Identify two key practices that enhance the efficiency of Dr. Booth’s surgery procedure.

1. Having a dedicated nurse team and anesthesia team to work with him in the OR and running two ORs simultaneously

a. The nurses would know how he liked his instruments passed so he didn’t need to look up, as well as knowing his exact procedure timings. The anesthesiologists knew that he preferred catheter based spinal epidural against general anesthetic which needed more skill so he only would have the medical teams with him who understood the process and were prepared.

b. While he was completing one patient the second OR could be prepping the next patient so there was minimal down time

2. His process around instrument use and selection was very streamlined.

a. Booth utilized only one supplier; Zimmer.

b. Booth selected specific instruments to use in every case as well as ran a redundancy audit every year to check which instruments were used, Those that were not used would be put in sterile storage.

c. Booth expected the exact instruments on the table every time as it fitted within his process. He rewarding the supplies department with game tickets when there were no mistakes, further minimizing delays in his process

Question 2: What benefits and downsides do you see in the focused procedure that Dr. Booth has developed?

1. Benefits.

The benefits are clear when reading through this case.

I. Reduced surgery time results in better surgical outcomes and a lower risk of complications. Reductions in complications obviously decrease costs associated with side effects; clots or infection, as well as any malpractice claims. Better surgical outcomes increase the rankings and reputation of the hospital which in turn pulls more patients into the hospital

II. Limited procedural variety (in this case; knees only) allows a standardized surgical process to be followed reducing the risk of error in the OR and decreasing time; thus ultimately saving money.

III. Patient selection is optimized (by using a standing X-ray mode) thereby reducing numbers of unsuitable candidates selected for surgery

IV. Using only one supplier allows for increased bargaining power around discounts of instruments. If there are any problems; it is easier to have one company to solve the problems rather than wasting time trying to find which company supplies the product. Less inventory needed on shelf, another cost reduction

V. Using the same nursing and anesthesiology teams drives loyalty, consistency in the