• Sidebar: Key Elements of OR Redesign

    Apr 14, 2011

    The following are common problems and solutions to improve OR efficiency processes:

    Staffing

    • If your OR exceeds benchmark staffing ratios for OR techs, nurses, and other specialty personnel, explore whether this is appropriate given your patient population and what the additional staffing costs are.
    • Staffing must match the workload. This will save time in both overutilized and underutilized hours. If staffing does not match the workload, it may lead to negative contribution margins, decreasing physician and staff satisfaction, and longer lengths of stay.

    Delays

    • Consider a daily huddle with the surgical team to talk about surgeries on the schedule for that day. This meeting ensures that errors in communication, preoperative prep, equipment cleaning, and availability can be avoided.
    • Set reasonable and tangible goals for turnaround times and delays by specialty and by surgeon.
    • Improve process flow by designating responsibilities to specific employees.
      • RN/extra tech: Pick up trash and any other items. Keep room as clean as possible during case. Disconnect cords and suctions as appropriate. Put solidifier in suction canisters.
      • RN: Call reports and make sure all paperwork is done as much as possible.
      • RN/float/extra tech: Ensure extra equipment is in the room for the next case or just outside the room to be moved in.
       
    • Create a system of disciplinary action.
      • Set up a mandatory meeting with the OR director when surgeons miss their start.
       
    • Call patients a day prior to their scheduled surgeries to discuss preoperative instructions, answer questions, and avoid same-day cancellations.
    • Improve turnover times.
      • Standardize setup and cleanup protocols by specialty type and by case type.
      • Adjust cleaning staff load to focus on time of day when many cases are being performed.
      • Add one or more turnover teams.
      • Make sure sufficient equipment is on-site to perform without reprocessing (Dexter, F., "Economics of Reducing Turnover Times," www.franklindexter.net/Lectures/TurnoverTime.pdf).
       
    • Use historical data to improve scheduling. Examine the average time it takes each surgeon to perform different types of surgeries, and schedule accordingly so resources are not wasted on overutilized or underutilized ORs.

    Source: HealthCare Transformation, LLC 

    Return to related article: How to Rapidly Improve OR Efficiency

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