Improvement of surgery department performance after implementing hospital quality standards' policies: two decades experience

Background Theodor Bilharz Research Institute (TBRI) Hospital comprises clinical departments, research laboratories, and different supporting services. General Surgery Department (GSD) in TBRI hospital has over 30 years of cumulative surgical and research experience. New managerial policy and quality procedures were developed and implemented from 2007 onwards in GSD. The aim of this study was to assess the pattern of change in utilization and performance in GSD in TBRI hospital after implementing the new policies and procedures, from 2007 onwards. Methods This was a retrospective observational study. Electronic data were collected from the medical record unit and annual reports of TBRI hospital from the year 2001 to the year 2016. Hospital utilization indices, admission, surgical operations performed, bed utilization indices, average length of stay (ALOS), bed occupancy rate (BOR), bed turnover rate (BTR), and mortality rate (MR) were calculated before and after implementing the new policies and procedures from the year 2007 onwards. Results The shift to more skilled and major surgical operations was doubled, and the increase of elective surgeries increased to more than three-folds of emergency operations. There was marked increase of outpatient flow to more than three-folds, and decreased MR. The indicators used to show increase of performance in GSD were as follows: improvement in hospital bed indices decreased ALOS, increased BOR, and increased BTR. The year 2016 showed the optimization of all hospital indices: ALOS 5.5, BOR 74.2, BTR 48.9, and MR 0.1. Conclusion Quality improvement may not appear in the initial years of a program. It is recommended to keep up the implemented hospital quality policies and procedures to continue future improvement for better quality of patient care in GSD at TBRI hospital.