6 Tweaks to Improve the Efficiency of Hospital ORs

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Small tweaks can improve a hospital's operating room efficiency, boosting communication with physicians, trimming turnover times and leaving patients and families more satisfied with their experience. Here, Robert Friedberg, vice president of operations at Central DuPage Hospital (CDH) in Winfield, Ill., and Jay Rindenau, MD, coordinator of clinical outreach at St. Vincent Medical Center in Los Angeles, share six tips to improve OR efficiency while maintaining patient safety.

1. Give physicians the opportunity to set schedules the day before. Poor scheduling is one of the leading causes of lost OR time. CDH tries to avoid this by having physicians contribute to OR schedules and case duration estimates based on individual patients. "Physicians may know something I don't. The patient might be a bit more difficult, and they want to add 20 minutes," says Mr. Friedberg. CDH locks OR schedules for the next day at 11 a.m. By going over schedules with surgeons the day prior to the procedure, CDH ensures surgeons are comfortable with the sequence and time intervals before it is locked in.

2. Communicate with physicians prior to prep-time. Start-time tardiness can bungle OR scheduling for the rest of the day. Fortunately, CDH works hard to maintain promptness on their end. "We have extensive communication with physicians. We make sure they're on campus, available and ready to go before their start time," says Mr. Friedberg. If there are issues with any one physician, it is managed by the medical director. "We also have an active OR committee, and the chair reviews all kinds of times or issues related to performance," says Mr. Friedberg.

3. Keep OR directors and managers in the loop. "Our OR director and OR managers are on the floor all the time. They're not in their offices — they're interacting with physicians," says Mr. Friedberg. An electronic board in the OR department helps surgeons understand what is going on in each OR and how long surgeons are expected to be in the room. "We have status boards in the OR and patient tracking boards in key locations," says Mr. Friedberg.

4. Family liaisons strengthen communication and alleviate workload for nurses and physicians.
CDH uses a few different strategies to communicate with the families, and one of the methods is what the hospital calls "purple coats." "These are the staff members who are in purple lab coats, going back and forth between ORs, recovery rooms and waiting rooms," says Mr. Friedberg. The purple coats give status updates, creating a clear line of communication between families and their loved one while not distracting other staff members.

5. The use of double rooms can improve throughput. CDH's high-volume surgeons often work in double rooms with two different teams if they are available, enhancing efficiency and decreasing wait times. "They go from room-to-room, bouncing back and forth. We have 26 ORs, and typically, two or three work as doubles for a surgeon," says Mr. Friedberg.

6. Poor communication means opportunity costs. Since the OR department is the largest revenue generator of a hospital, missed opportunities can mean significant costs. "We have an OR sitting with an entire date staff waiting to do something and getting paid," says Dr. Rindenau. Blood tests, imaging and various other services can delay surgeries if times are not coordinated and clearly communicated. "ORs need to have a culture of communication," says Dr. Rindenau.

Read more about OR efficiency:

- 7 Lax Habits of Otherwise Highly Effective Surgeons

- 3 Ways to Achieve Excellent Patient Throughput

- Lessons From Aviation Applied to Hospital ORs


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