Clinical Practice Specialist Valley Hospital Hillsdale, New Jersey, United States
Description: Our operating room’s average turnover time was greater than the goal time of 35 minutes. Efforts to reduce the time were not yielding any improvement. The average room turnover for cases with same surgeon was 38 minutes. Planning of a Value Stream mapping workshop in conjunction with the Quality and Performance Improvement Department occurred. Key members of the entire perioperative team, including Same Day, PACU, OR staff, orderlies, anesthesia techs, and the leadership team along with the Performance Improvement Coordinator established a goal of improving OR turnover time to increase efficiency in the Perioperative Areas. Through the utilization of LEAN methodology, mapping of the current state followed. . During this process, there was the identification of 47 pain points. Next, those that do the work designed a future state. In order to achieve a process that mitigated these pain points, the team designed three rapid improvement events as follows: • Patient not ready on time • Standard work for OR turnover – PIT crew mentality • Preference cards correct, case carts picked correctly, and knowing what trays to open Each rapid improvement event required a team, with a team leader for each. In order to improve these key issues development of a problem statement, with event target outcomes was the first step. The team went on to develop key metrics, variables to test, and set a time for completion. The patient not ready on time for OR improved from 79% not ready, to 43% not ready. Of the 43% not ready, 87% of the time it was a provider issue, and not related to the current processes. Analysis of this data allows for the Chief Medical Officer and Chief of Surgery to implement targeted countermeasures to address issues in the current provider workflow. The Main Sterile Area staff, Central Processing team, and Service Line Supervisors continue to work together to ensure supplies needed for OR cases are available and correct. Preference cards are in the process of verification. Initiated with Robotics, and then moving to neurology, the team will continue until all service lines are updated and correct. Standard workflow for room turnover is in the development stage. Orderlies, anesthesia techs, housekeeping, circulating RN’s and surgical techs are currently involved in designing and implementing a process that will work for each team. With not all improvements in place, the current room turnover average is 34 minutes. The team continues to work on these improvement plans and to continue expanding the process to include enhancements to the Main Sterile Area as well as review of other processes that will yield improvement in the OR turn over time.