OPERA-Note (OPENO) Case Studies

Key point

Reduced training burden and improved efficiency

At our hospital, we perform over 10,000 surgeries a year and have 70 surgical staff, half of whom have less than five years of experience. The problem was that we had to train workers after hours because we had difficulty secure time during day shifts. Therefore, we wanted to reduce the training burden by using video and digital tools.

Change after introduction

OPENO enabled us to encourage a habit of self-learning

Thanks to OPENO, we were able to digitize 232 procedural manuals numbering more than 800 pages. Making OPENO available on smartphones and other devices has also enabled individual workers to view their surgical schedules and shifts, which has increased OPENO’s utilization rate. Usage logs have also revealed that workers have embraced a habit of self-learning by checking their surgical schedules and confirming the relevant procedures in advance.

Key point

Created standards to prevent incidents

Since our hospital was relocated, the number of surgeries has increased rapidly, requiring us to raise worker numbers. As a result, 40% of our workers were supporting the other 60%. These circumstances led to an uptrend in incidents, creating an urgent need to improve our training programs and create a time-tested environment where clear standards can be shared.

Change after introduction

Better use of spare time; no more contact notes

At the time of introduction, we collated our knowledge and exchanged opinions with doctors. Since introduction, surgery preparations have become smoother, and part-time workers and those working shorter hours can now share information in their spare time. We have also devised a way to share daily communication notes on OPENO, which used to take time to update and check.

Key point

We got rid of disorganized manuals

At our hospital, we perform just under 5,000 surgeries a year. Our operating room, where patients are subjected to a great deal of invasion, plays a major role in ensuring safety. However, we noticed an increase in incidents and employee turnover rate, prompting us to perform a SWOT analysis of our operating room to clarify its weaknesses and strengths. One measure we took was to improve our training manuals, and we introduced OPENO in order to help get rid of the disorganized manuals.

Change after introduction

We created an independent, self-directed learning environment

Thanks to OPENO, newcomers who previously had to ask their seniors where to find the manuals can now prepare and study on their own, thus reducing stress on both sides. OPENO also enabled us to standardize our training manuals, which were original to each department and inconsistent. We have installed one terminal in each room so workers can check and input their OPENO status while performing surgery, which has improved the platform’s utilization rate.

Key point

Improve daily learning environment, starting with the search for training manuals

Our procedural manuals were kept in files that were often lost or misplaced. They also tended to contain mainly personal notes that were not kept up-to-date, which was a problem.
When new nurses were going through their daily learning process, they had to search for training manuals. Some existed and some didn’t, some existed but were missing, some were not properly updated, and some had other materials attached. New nurses also needed to confirm many matters with their preceptors, and frequently had to wait until after the day shift for the preceptors to be available.
By using OPENO, we hope to avoid loss, keep information up-to-date, standardize forms and related materials, and quickly access procedural manuals and other necessary materials. We want to create an environment where workers can make effective use of their precious learning time.

Change after introduction

Under preparation

Key point

Easy tool that uses videos and photos for visualization

For JCI accreditation, we were required to standardize the format and management of our procedure manuals but were unable to respond quickly due to our hospital’s particular circumstances, high degree of specialization, and other variations. In addition, accessing our manuals entailed a process of “searching, copying, and learning,” which was time-consuming and costly. In response, we introduced OPERA-Note, a visual system featuring videos and photos, enabling staff to share information and gain easy access anytime and anywhere in line with their lifestyles.
By using OPERA-Note, we hope to avoid loss, keep information up to date, standardize forms, and provide links to related materials, as well as to allow prompt access to necessary procedure manuals, related materials, and other information. In the process, we aim to help our staff make the most of their valuable learning time.。

Change after introduction

Making the most of OPERA-Note

We created our own OPERA-Note team, which has taken the lead in deploying video and photos for the system. Our videos and photos have been extremely effective, and many staff members have expressed a desire to make more use of them. Initially, we introduced the system mainly for use within the hospital, but its utilization rate gradually increased, prompting more and more requests from outside the hospital to use the system for self-learning purposes, in addition to within the hospital. Since April 2022, therefore, we have expanded the system to cover the personal terminals of all staff members (numbering around 100), enabling information to be checked anytime and anywhere.
Our hospital has also begun using OPERA-Note as an educational and information-sharing tool for younger staff in the clinical engineering office, in addition to operating room nurses. We plan to continue making maximum use of OPERA-Note to facilitate teaching and learning.

Key point

Consolidating information to increase the “density” of our procedure manuals!

Previously, we managed a wide variety of documents, such as procedure manuals, material/instrument lists, and surgery room settings, on paper. We then thought that consolidating information using OPERA-Note would make searching and viewing documents more efficient, and we could expand the system to enable paperless surgical experiences and ladder evaluations. The use of videos and photos to convey room settings and instrument deployment materials was also visually appealing.
By using sticky notes and messages to make changes, we aim to use the system as a tool for transferring work to contractors that is unbound by individual experience levels.

Change after introduction

Diversifying utilization methods to promote operational efficiency

Thanks to OPERA-Note, we succeeded in creating a paperless surgical procedure manual and procedure video. When creating the video of the procedure manual, we enlisted the help of doctors and added the perspectives of technically skilled nurses, a process we found enjoyable. By also having frontline medical workers use the system, we can eliminate discrepancies in the information used to create surgical room settings, leading to more efficient operations.
In the future, we plan to include the Tama Surgical Nursing Ladder in our OPERA-Note system so we can conduct evaluations in real time.

Key point

Promoting team care through standardization of procedures and education

Our hospital is a secondary/tertiary emergency facility with 6,000 surgeries per year and 37 nurses. By introducing OPERA-Note, our aim is to improve the quality of work by centralizing scattered materials and introducing tools to facilitate video training, thereby increasing the efficiency of training methods and eliminating oral training. We also believe that standardizing procedures and education will have a positive impact on safe team care among physicians and nurses.

Change after introduction

Under preparation

Key point

Improving our surgical environment (information sharing and educational environment for operating room nurses)

Through OPERA-Note, we used 2D photos, videos, and printed text to create a manual that enables surgical information, which changes daily, to be easily shared.
On the education side, we lend smart devices to operating room nurses, allowing them to access manuals and the clinical ladder quickly as needed, anytime and anywhere. This provides increased learning options for our nurses.

Change after introduction

Making greater use of IT

To address the needs of operating room nurses with differing employment and work schedules, our OPERA-Note system stores videos of special instrumentation manuals, various learning sessions, and study groups, creating an environment that enables learning at any time. In the future, we will make full use of IT to further improve the quality of nursing care and positively benefit our surgical care team.