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Streamlining Surgery Day Processes for Efficient OR Utilization

Explore the challenges and solutions in optimizing the day of surgery flow from first incision to patient discharge on the floor. Address communication gaps and time inefficiencies to enhance patient safety and operational efficiency. Key areas: Hand-off communication, turnovers, urgent case management.

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Streamlining Surgery Day Processes for Efficient OR Utilization

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  1. SIP 3 Day of Surgery: After first incision until midnight

  2. Process Flow 1st Patient OR PACU Discharge/ Floor 2nd Patient Floor/ Check-In Pre-Op OR PACU Discharge/ Floor 3rd Patient Floor/ Check-In Pre-Op OR PACU Discharge/ Floor

  3. Call for next patient Close Patient 1: Pt Out OR Pt ready to go to OR Patient 2: Pt In OR IP PAV Data • An overlap of activities occurs between the current case and the following case, playing a vital role into the continuum of the OR day

  4. Data • Average turnover time and prep time vary according to site: • Main: 71 min • Main Annex: 63 min • Pavilion: 48 min • Roosevelt: 34 min

  5. Issues • Hand-offs of patients and between staff make transitions difficult • The process is not visible and staff do not know if and when critical activities have occurred • Information sharing via paper or verbal does not happen in a timely manner • Changes in plans are not communicated to everyone • Paging or contacting the appropriate staff/faculty is time consuming and difficult • A balance must be made between surgery and education

  6. Analysis • Communication plays a major role in all aspects of the process • By reducing the turnover time and prep time, it will allow for maximum amount of OR utilization for patient safety

  7. Key Areas of Focus • Communication at Hand-Off • “Briefing” • Turnovers • TBA and Emergent/Urgent Case Management

  8. Obstacles • Culture – Everyone must work together as a team to meet a common goal • Culture – Each individual does not need to be efficient as long as the entire system is effective • Political – Each “group” has their own agenda

  9. Current Activities • 5S Events • Equipments (x2) • Turnover Prep • RPI’s - Turnover • Team Projects • Standardized Report at Hand-off • Briefing of the rest of the day

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