1. Regional Block Coordinator Role
Introductions
Getting Patients there on time
Leanne Davis, BSN, RN, CPAN & Alicia White BSN, RN, CAPA

2. University of Virginia Outpatient Surgery Center
Thirty to seventy-five patients each day
From two to twenty-seven blocks performed in pre-op
Up to seven first-start blocks
Anesthesia team consists of one resident, one or two fellows, and multiple attending anesthesiologists
Five designated block rooms in pre-op
Rescue blocks done in PACU on occasion

3. Benefits of the Regional Block
Improved postoperative analgesia
Decreased need for postoperative opioids
Fewer adverse effects in comparison to IV narcotic treatment
Facilitates early physical therapy and rehabilitation
Decreased length of stay
Decreased risk of chronic pain

4. Why Preoperatively? Patient safety Better utilization of turnover time
Block as primary anesthetic

5. The Downside of Pre-op Blocks
Delays in the patient getting into the O.R.
Decreased productivity
Increase in O.R. cases running late
“Domino effect” on staffing
Decreased patient and staff satisfaction
Increased costs

6. Prior State
Little communication between regional block team and nursing
Uncertainty on nurse’s and anesthesiologist’s part of which patients would get blocks
Surgeons had no concrete point of contact
Blocks happening all over pre-op
First-case on-time starts for blocks at 36%

7. How Could We Make This Better??
Designate one FTE to be full-time regional block coordinator
Started in April 2017
Works in conjunction with pre-op & OR charge nurses
Closely communicates with nursing, anesthesia, and surgery

8. Starting the Improvement Process
Observation and documentation
Delay reasons
Suggestions for improvement
Weekly huddles with nursing and physician leadership, administration, and our Be Safe coach
Implementation of visual management boards
Spreading the word

10. A typical block day in OPSC
Tracking delays in real time
A typical block day in OPSC

11. Current State
Block coordinator sorts out who needs a block the afternoon prior
Pre-op nurses assigned to block team depending upon how many blocks scheduled & timing of blocks
Block coordinator acts as “ground traffic control” prioritizing blocks
Changes are communicated by the surgeons and anesthesiologists to block coordinator who adjusts schedule appropriately
All block equipment and supplies are responsibility of block coordinator
First-case on-time starts sustained >70% for over a year!

12. Tips & Tricks for Multidisciplinary Practice Change
Attitude and approach are everything
Be flexible!
Servant leadership
Whatever it takes to keep things moving
Here to help, not to dictate
Focus on the team

13. What did we Improve? FCOTS from 36% to sustained >70% Communication
Collaboration
Patient Safety
Patient Satisfaction
Staff Satisfaction

15. Where We’ve Been and Where We’re Going!
VSPAN 2018, VA Beach, VA
UVA’s “Situation Room”
UVA 2018 Evidence Based Practice Symposium
ASPAN 2019, Nashville, TN
VSPAN 2019, Staunton, VA

16. Teamwork Makes the Dream Work!

17. Questions?