At United Medical Center in Batavia, N.Y., Deborah Spratt, MPA, BSN, RN, the director of surgical services, noticed the operating room could be more efficient with first case start times and turnover. So, she started an OR efficiency project at the hospital.
The project, outlined in an edition of OR Exec from the Association of periOperative Registered Nurses, included the following six improvement processes:
1. Improve the scheduling process. United Medical Center is still working on perfecting the booking sheet and scheduling process, as Ms. Spratt says the hospital is on its tenth version, and it is a "work in progress." Another obstacle to overcome is getting all the surgeons to use the OR booking sheet.
2. Using another housekeeper when necessary. Working off of benchmarks from the environmental services department, United Medical Center now calls in an extra housekeeper to help with turnover if there are more than 16 cases in the OR that day.
3. Using parallel processing more frequently. Some surgeons are allowed to run more than one room at once, according to Ms. Spratt. When that happens, the hospital uses a facilitator — often a registered nurse-first assistant — to help things run smoothly.
4. Starting daily huddles. The OR has a roughly three-minute huddle every morning to look at the schedule and talk about anything new or different happening that day. For individual ORs, the huddle also discusses the schedule and any special instruments or patients with surgery and anesthesia.
5. Optimizing preference cards. Since preference cards are of upmost importance when setting up back tables in the OR and smoothing transitions, it is essential to have them as accurate and detailed as possible. At United Medical Center, members of the team go back and look at the preference cards to make sure they're in the best shape possible.
6. Standardizing table setups. A technician at United Medical Center standardized the setup of the back table so in emergencies or when someone comes in to relieve another person, they know where everything should be. IT makes for a smoother transition and can also cut down on sharps injuries, according to Ms. Spratt.
While there isn't hard data available to show how these six initiatives have helped make the OR more efficient, Ms. Spratt said the project has been successful. "I think the project has definitely helped with team building and helped develop an understanding of what goes on in the rooms," she told OR Exec. "It's brought about some positive changes, but there's still work to be done."