The following are key observation points when conducting an operating room (OR) assessment:

Staffing 

  • OR overutilized (staff working overtime during cases scheduled outside of their scheduled hours)
  • OR underutilized (staff being paid when the OR is not in use)

Delays 

  • Preoperative delays
    • Late start times:
      • Patient, surgeon, and/or anesthetist is late
      • Equipment failure
      • Understaffing (emergency situations)
      • Late equipment setup
      • Inadequate equipment available
       
    • Same-day cancellations
      • Patient cancels the day of surgery
      • Surgeon unavailability
      • Full ICU
     
  • Perioperative delays
    • Late getting into OR suite
    • While in OR suite:
      • Insufficient preoperative preparation
      • Communication failure
      • Contamination
      • Errors in job performance by physician, tech, nurse, or anesthetist
      • Malfunctioning or missing equipment
      • Turnover times (long turnover times are likely due to set up and clean up; however, there is a benefit to looking at turnover times by time of day, which can illustrate that the delay is not due to inefficient operating staff, but inefficient scheduling of cases, equipment available, or staffing)
       
     
  • Postoperative delays
    • Delay on postanesthesia care unit admission
    • Other issues that delay patient leaving the OR, such as pain management and appropriate bed availability
     

Source: HealthCare Transformation, LLC 
 

Return to related article:How to Rapidly Improve OR Efficiency 

Publication Date: Thursday, April 14, 2011