Preoperative Paperwork Initiative

Abstract

Although Joint Commission and hospitals strive to improve safety by instituting requirements for perioperative paperwork, the timeframe for when this should be available on the chart is undefined in most institutions. At the University of Colorado Hospital, data shows history and physicals (H&P's) and preoperative orders are completed at the bedside 10 minutes or less before surgical start 21% of the time. Preoperative nurses scramble to ensure necessary documents are completed and orders are carried out appropriately for the safety of the patient ultimately causing delayed OR starts and orders. Perioperative Services' plan for improving this process was a comprehensive initiative which included EMR training for physicians and RN super-users, instituting a standard that included preoperative orders available for nurses to act upon two hours before surgical start time and H&P’s available 20 minutes before surgical start time.