Identifying operating room delays for the first case in an ophthalmic ambulatory surgery center

Abstract

Introduction. Starting the first case in the operating room (OR) on time leads to efficient scheduling; optimized use of time and resources. We assessed if a delayed start of the first case was occurring, if on- time completion at the end of each session was achieved, and identified delaying factors.Methods. An initial pilot study of twenty-six sessions found an average delay of 15.4 min. Based on ASC nurse and technician perceptions, one ASC nurse recorded delays as either late surgeon or patient arrival, extended patient interview, delay in anesthesia; equipment or OR delay. Data from the end time of sixty-three sessions were analyzed.Results. Of 63 sessions, 54% started past the scheduled start time. The average OR delay was 5.05 min. Seventeen sessions were late due to surgeon arrival, one from anesthesia arrival, three with difficult intravenous catheter insertion, one from an extended patient interview, five from equipment malfunctions; seven from OR delays. Thirty-three sessions concluded past scheduled end time; the average completion was 4.6 min past the scheduled end time.Conclusion. Late starts are minimized with physicians arriving on time, prompt assessment of equipment function and supply needs for each case after staff arrival, and the effective communication of physician arrival. First case on-time start is one factor, but turnover times and case durations are more influential in finishing a session late.