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HLTH SC 3102 : Service Improvement and Innovation in Health : Social C


1. Demonstrate relevant understanding of service improvements and innovations in health and social care settings and discuss those that are pertinent to their own work place. ( working in the theatres)
2. Discuss one relevant improvement programme within their own work setting and review it using appropriate nationally recognised benchmarks.
3. Identify their own role (Assistant practitioners (scrub nurse). boundary/ limits and make constructive suggestion for improving service for service user/ patients/ caters and the public, within their work setting.
4. Reflect upon their personal contribution to a service change introduce to improve service for one client/ patient group.



In this twenty-first century, in order to continue to respond to changing patients' needs and remain clinically and fiscally appropriate, there must be an overall effort on the health care framework to address the diversity of quality and outcomes. We need a set-up of service improvements and innovations in healthcare that exclusively and aggressively support the necessary improvement. Implementing innovations requires representatives and associations - intellectually, internally, physically, and deeply (Srivastava and Shainesh 2015). When seeking to update events, associations encounter difficulties, for example, inadequate salary hike, professional boundaries, conflicting needs and idleness. The heads of the centers, which are run by the association's employees and watch the representatives in the foreground, can take part in overcoming these difficulties. To adequately implementing innovations representatives need to have data on what to do, how and when to do so, and why they need to do so. Gaps in these data make tiring for workers to achieve a common sense of vitality in order to make progress.

Service improvements and innovations in healthcare and social care in theaters

In this era of financial distress, huge reserve funds must be made, while preserving the quality of the medical services provided. This has led to the idea of ??productivity improvement and prevention of quality improvement called QUIPP (Lin et al. 2015, p 87). One of the focus areas is to increase the profitability of the workplace. Impressive consumption in professional performance centers is led by the Institute for Innovation and Improvements to the National Health Service (NHS) t

o supply QUIPP, called The Productive Operative Theater (Mason, Nicolay and Darzi 2015, p 91). This is the scope of procedures intended to provide a deliberate way of transmitting changes in the well-being, skills and outcomes of patients to the work room, while reducing cost. Although there are numerous imperative techniques in "Productive Operation Theater," one of the main ideas is “Lean Methods”. The main idea in the Lean hypothesis is the consistent distinctive evidence and expulsion of waste or "Mudu" (Japanese of waste) (Nyweide et al. 2015, p 52), which improves quality while reducing the time and costs of creating (Mason, Nicolay and Darzi 2015, p 91).

Service improvements in theatre productivity

There are generally 7 types of "wastes" that needs to end, given the ultimate goal of increasing efficiency in theaters. By assessing every kind of waste in relation to operation theaters and accessing the daily routine, it is clear how to realize the improvements for the profitability of the theater. Let's look at the examples:

  1. Overproduction: It implies processing a request before it is needed. It includes those procedures that take place in a predefined fashion without considering its current benefits.

Example include: requesting certain preoperative tests for all patients, provided they can be withdrawn or postponed or that they do not have them when most of these tests do not alter patient management.

Solution: Optimize the ex-ante evaluation so that it is evidence-based and gives a clear and easy-to-read direction when certain tests should be required (Fong, Smith and Langerman 2016, p 71).

  1. Waiting: any kind of delay that brings nothing profitable to the staff member.

Examples include staff member waiting for the patient to go down to the theater and sit in the cafeteria without doing anything.

Solution: Use and connect more caretaker so there are fewer postponements when transferring patients to the theater (Sacks et al. 2015, p 58).

  1. Stock: Purchase stock before it is necessary to ensure availability of abundance of stocks.

Example include: acquiring and then retaining plenty of theater facilities or tranquillizing medication. Surplus inventory includes space and makes the various procedures less relevant, i.e problems in finding an urgent sedative medicine, as it is covered by an "ocean" of various drugs, which leads to delay in work. Excessive supply of medicines may also give the false impression that the drug has expired and is then further delivered illegally, resulting in an overrun (Sacks et al. 2015, p 58).

Solution: Organizing the most commonly used medications in alphabetical order with only 1-2 boxes of each drug (Fong, Smith and Langerman 2016, p 71).

  1. Transport misuse: It must be possible to develop hardware, items or faculty to guarantee work.

Examples include a loss of time, transferring patients from the detachment to a theater or hospital.

Solution: Optimal geographic layout of the theatrical complex to rationalize the flow of patients (Morgan et al. 2015, p 11).

  1. Deformations - A down-chain error requiring intercession at a later stage, which results in postponement of the entire process's performance to the point where huge savings could occur if the error is identified and tracked accurately on time (Mason, Nicolay and Darzi 2015, p 91).
  2. Waste of over-processing - waste of meaningless assets to create a comparable effect.

Illustrations include providing patients with a nerve block, an epidural, and a general analgesic for surgical treatment, when general sedative and local infiltration can produce proportional results and be completely saving time.

These include patients scheduled for a medical procedure where appropriate pre-operational documentation is not completed and this is established once in the theater, resulting in postponements during working hours while the documentation is complete and the potential delay of a later patient.

Solution: Healthy check frames before patients go to the theater (Mason, Nicolay and Darzi 2015, p 91).

  1. Movement - when a staff member / nurse has to move more than once to carry out his / her activity.

The illustrations include constantly moving around the theater and quiet space to receive medicines, facilities or potential waste disposal.

Solution: A skillful movement where everything is effectively accessible with minor movements (Mason, Nicolay and Darzi 2015, p 91).

Improvement programs in health and social care settings

The Operational Theater Program, launched in London by the Institute for Innovations and Improvements, is the latest in the ranking of projects with the Production Department. The activity invites front-line employees to identify problems with their work systems - specialized and social - and to find ways to settle them. Understanding critical surveys and an annual review of staff behavior were known to distinguish development territories and measure progress. In addition, an "off-site" meeting must be held involving all the people in the cautious group to consider the current working method (Mizumoto, Cristaudo and Hendahewa 2016, p 83). Among the top dissatisfaction was the over-running of lists, which implied that employees usually need to work for late hours every night and postpone early hours at the start of the day, usually due to their inability to find the equipment.

Improvements must include better storage and labeling of equipment, and a clock must be placed in the ward where patients can look. The "fastest effect" mediation needs to be provided. The discussion regarding briefings on the patients' day from the beginning till the end of the day must be planned. The briefings will allowed all staff to conduct an open discussion twice a day (Mizumoto, Cristaudo and Hendahewa 2016, p 83). Preparing for the start defines the scene - the group examines all the patients of the day who were previously summoned. The question of completing the retrospection allows the group to investigate what happened well, what they can rejoice and what they can mend. "

The program is prompted to increased start-up hours, reduced congestion, reduced caseload, and increase staff satisfaction (Page 2014). "The program is not for deadlines; it is tied to the acquisition of control of the workplace in more efficient manner and works even more successfully. This is a victory, gaining circumstance from a staff's point of view. A program that engages theater medical staff and other care staff to implement improvements day-to-day work can improve both the performance of staff and the quality of the administration.

Constructive suggestion for improving service for patients

The valuable proposal to improve administration for patients with step-wise approach includes:

  • A fifteen-minute pre-operative patient area warning: telephone call from the theater to the pre-operative region, which is expected to ensure the culmination of the patient's preparation for the theater (Fong, Smith and Langerman 2016, p 71). It was an open door so that the patient could, if vital, complete some outstanding print material and accumulate the lectures from the healing center and ensure that the patient is properly dressed for the theater (Barrett et al. 2016, p 35).
  • Mobilize a dedicated cleaning team: A dedicated cleaning group consisting of two health care professionals who precede this endeavor to change quality should be used (Sharma, Conduit and Hill 2014, p 79). The entrance will recommend a 5-minute warning to ensure that they can prepare wipes and cans for cleaning to start when they are right and immediate (Roberts et al. 2017).
  • Simultaneous cleaning and transferring: Obviously, watching the feedback times in the theater are grounded and prepared before they are sent for the next results to patients with meaningless depositions. The circumstances required for cleaning and dispatching for a patient are reliable, and the transfer may then commence at the same time (Roberts et al. 2017).
  • The ODP specialist should be invited to leave the theater quickly after a medical procedure to register the next patient instead of doing it in the middle of the turnaround time. This is largely due to the fact that the patient has made a few queries and completed the printed materials (Acharya et al. 2017, p 2).

Personal contribution to a service change

My own commitment to change the administration, get acquainted with increasing the benefits for a group of patients will include gaining co-ordination from the staff for bringing the necessary changes. Bringing innovation requires careful planning and careful planning with staff, modification and their concerns. Staff should focus on change to ensure that culture changes within a foundation, coming up to support change (Witell et al. 2016, p 63). The ageing population is likely to increase in the coming time. Failure to increase yields, despite the ageing population, will lead to delay in treatment provision; will cause a disaster, reduced personal satisfaction and even more mortality (Halim, Khan and Ali 2018, p 60). Enhanced knowledge with more prominent audiences will reduce the underlying health conditions in a routine medical procedure. Hamilton and his partners have assumed that timing is one of the three variables that improve understanding of performance with the theatrical administration, so it is essential that every effort is made to ensure that retention time is maintained (Raine et al. 2016).


This endeavor aims to distinguish the inadequacies and the postponements of the treatment time in the operation theater. Several areas of improvement were effectively differentiated, keeping in mind the ultimate goal of streamlining the redemption procedure. After submitting; a fifteen-minute alert to rooms for preliminary accommodation, patient checked in pre-operative rooms instead of theater, patient sent for pre-completion of theater cleaning at the end, five minute warnings given to staff to clean the theater; it is likely that a significant reduction in the average reversal time will occur (Weld et al. 2016, p 08). Obviously, expanded competence would allow more tasks to be recorded each day and thus lead to abbreviated record keeping, which reduces patients' anxiety. If these changes can somehow be operational, theaters can be more efficient & huge economic savings can be achieved.


Acharya, B., Maru, D., Schwarz, R., Citrin, D., Tenpa, J., Hirachan, S., Basnet, M., Thapa, P., Swar, S., Halliday, S. and Kohrt, B., 2017. Partnerships in mental healthcare service delivery in low-resource settings: developing an innovative network in rural Nepal. Globalization and health, 13(1), p.2.

Barrett, M., Davidson, E., Prabhu, J. and Vargo, S.L., 2015. Service innovation in the digital age: key contributions and future directions. MIS quarterly, 39(1), pp.135-154.

Fong, A.J., Smith, M. and Langerman, A., 2016. Efficiency improvement in the operating room. journal of surgical research, 204(2), pp.371-383.

Halim, U.A., Khan, M.A. and Ali, A.M., 2018. Strategies to Improve Start Time in the Operating Theatre: a Systematic Review. Journal of Medical Systems, 42(9), p.160.

Lin, Q.L., Liu, H.C., Wang, D.J. and Liu, L., 2015. Integrating systematic layout planning with fuzzy constraint theory to design and optimize the facility layout for operating theatre in hospitals. Journal of Intelligent Manufacturing, 26(1), pp.87-95.

Mason, S.E., Nicolay, C.R. and Darzi, A., 2015. The use of Lean and Six Sigma methodologies in surgery: a systematic review. The Surgeon, 13(2), pp.91-100.  

Mizumoto, R., Cristaudo, A.T. and Hendahewa, R., 2016. A surgeon-led model to improve operating theatre change-over time and overall efficiency: a randomised controlled trial. International Journal of Surgery, 30, pp.83-89.

Morgan, L., Pickering, S.P., Hadi, M., Robertson, E., New, S., Griffin, D., Collins, G., Rivero-Arias, O., Catchpole, K. and McCulloch, P., 2015. A combined teamwork training and work standardisation intervention in operating theatres: controlled interrupted time series study. BMJ Qual Saf, 24(2), pp.111-119.

Nyweide, D.J., Lee, W., Cuerdon, T.T., Pham, H.H., Cox, M., Rajkumar, R. and Conway, P.H., 2015. Association of Pioneer Accountable Care Organizations vs traditional Medicare fee for service with spending, utilization, and patient experience. Jama, 313(21), pp.2152-2161.

Page, T., 2014. Notions of innovation in healthcare services and products. International Journal of Innovation and Sustainable Development, 8(3), pp.217-231.

Raine, R., Fitzpatrick, R., Barratt, H., Bevan, G., Black, N., Boaden, R., Bower, P., Campbell, M., Denis, J.L., Devers, K. and Dixon-Woods, M., 2016. Challenges, solutions and future directions in the evaluation of service innovations in health care and public health.

Roberts, H.W., Myerscough, J., Borsci, S., Ni, M. and O’Brart, D.P., 2017. Time and motion studies of National Health Service cataract theatre lists to determine strategies to improve efficiency. British Journal of Ophthalmology, pp.bjophthalmol-2017.

Sacks, G.D., Shannon, E.M., Dawes, A.J., Rollo, J.C., Nguyen, D.K., Russell, M.M., Ko, C.Y. and Maggard-Gibbons, M.A., 2015. Teamwork, communication and safety climate: a systematic review of interventions to improve surgical culture. BMJ Qual Saf, 24(7), pp.458-467.

Sharma, S., Conduit, J. and Hill, S.R., 2014. Organisational capabilities for customer participation in health care service innovation. Australasian Marketing Journal (AMJ), 22(3), pp.179-188.

Srivastava, S.C. and Shainesh, G., 2015. Bridging the Service Divide Through Digitally Enabled Service innovations; Evidence from Indian Health Care Service Providers. MIS Q, 39(1).

Weld, L.R., Stringer, M.T., Ebertowski, J.S., Baumgartner, T.S., Kasprenski, M.C., Kelley, J.C., Cho, D.S., Tieva, E.A. and Novak, T.E., 2016. TeamSTEPPS improves operating room efficiency and patient safety. American Journal of Medical Quality, 31(5), pp.408-414.

Witell, L., Snyder, H., Gustafsson, A., Fombelle, P. and Kristensson, P., 2016. Defining service innovation: A review and synthesis. Journal of Business Research, 69(8), pp.2863-2872.

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