PMID- 36171005
OWN - NLM
STAT- MEDLINE
DCOM- 20220930
LR  - 20221006
IS  - 2399-6641 (Electronic)
IS  - 2399-6641 (Linking)
VI  - 11
IP  - 3
DP  - 2022 Sep
TI  - Doing today's work today: real-time data recording and rolling audit in an IVF 
      clinic.
LID - 10.1136/bmjoq-2022-001943 [doi]
LID - e001943
AB  - The assisted conception unit at Sheffield Teaching Hospital NHS Foundation Trust 
      provides in vitro fertilisation treatment. A team of seven embryologists provides 
      a routine clinical laboratory service, involving culture and storage of embryos. 
      This requires a series of management and statutory data administration and 
      communication tasks.We were aware that these were often done many days after 
      clinical tasks, resulting in delays sending patient correspondence and 
      unavailability of clinical notes for multidisciplinary team (MDT) cycle-review 
      meetings. Embryologists also complained that transcribing data were 
      time-consuming and duplicated across our IDEAS software, spreadsheets and 
      paper.We process-mapped our processes and gathered staff views on problems and 
      potential solutions. The baseline average total cycle time (TCT) for completion 
      of all administrative steps was around 17 days; data administration time (DAT, 
      data 'touch time') was around 30 min per patient.We embarked on this Quality 
      Improvemen (QI) project to reduce waste in TCT and DAT, and to have data 
      available for patient communication and MDT deadlines. Exploration of IDEAS' 
      capabilities led to progressive realisation of how much could be transferred to 
      this single data system, removing a lot of off-putting redundancy. Through this 
      we developed a 'to-be' vision of all data entry being real time, as part of the 
      clinical 'jobs'. We conducted five Plan-Do-Study-Act cycles plus two more to test 
      performance and sustainability as changes bedded-in and an external constraint 
      disappeared.We have cut TCT to 0 or 1 days and DAT to around 18 min. All project 
      metrics are reliably within our targets, and data are now always available for 
      timely patient letters and the MDT. Other benefits include easy access for all 
      staff to patient records and removal of paper and spreadsheets. A further, 
      unanticipated, benefit was a switch from a tedious 2 yearly storage tank audit to 
      a more-agreeable and safer rolling audit.
CI  - (c) Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Wood, Lucy
AU  - Wood L
AD  - Assisted Conception Unit, Sheffield Teaching Hospitals NHS Foundation Trust, 
      Sheffield, UK lucy.wood12@nhs.net.
FAU - Proudlove, Nathan
AU  - Proudlove N
AUID- ORCID: 0000-0002-1176-8088
AD  - Alliance Manchester Business School, The University of Manchester, Manchester, 
      UK.
LA  - eng
PT  - Journal Article
PL  - England
TA  - BMJ Open Qual
JT  - BMJ open quality
JID - 101710381
SB  - IM
MH  - *Communication
MH  - *Fertilization in Vitro
MH  - Humans
PMC - PMC9528667
OTO - NOTNLM
OT  - continuous quality improvement
OT  - efficiency, organizational
OT  - information technology
OT  - process mapping
OT  - statistical process control
COIS- Competing interests: None declared.
EDAT- 2022/09/29 06:00
MHDA- 2022/10/01 06:00
PMCR- 2022/09/28
CRDT- 2022/09/28 20:52
PHST- 2022/04/08 00:00 [received]
PHST- 2022/09/13 00:00 [accepted]
PHST- 2022/09/28 20:52 [entrez]
PHST- 2022/09/29 06:00 [pubmed]
PHST- 2022/10/01 06:00 [medline]
PHST- 2022/09/28 00:00 [pmc-release]
AID - bmjoq-2022-001943 [pii]
AID - 10.1136/bmjoq-2022-001943 [doi]
PST - ppublish
SO  - BMJ Open Qual. 2022 Sep;11(3):e001943. doi: 10.1136/bmjoq-2022-001943.