Reducing Operating Room Traffic Through Audits and Process Improvement

Abstract

<h3>Background</h3> Surgical site infections are significant complications following operative procedures. Operating room (OR) traffic during surgical procedures may affect air flow in the OR suite and increase bacterial contamination of the sterile field. Measures to reduce OR traffic during surgical cases may decrease the incidence of surgical site infections. Our team set out to determine the incidence and reasons for traffic in our operating rooms and implement process improvements to decrease traffic during procedures. <h3>Methods</h3> An audit tool was developed to count the number of times doors to the operating room were opened between procedure cut and close. The audit was conducted by the circulating RN for 30 days for all procedures. Audit results were reviewed to determine traffic levels and reason for door openings. Traffic was measured in door openings per procedure. Process improvements were implemented based on common reasons for traffic. Measures implemented include placing fluid warmers and high use medications in each OR, updating physician preference cards and education for the OR staff, anesthesia and vendors on methods to reduce rooms entries and exits during cases. After implementation of process improvements, a repeat audit was conducted for 30 days to determine if there was a decrease in door openings per procedure. <h3>Results</h3> Results of the initial audit of 279 procedures showed the occurrence of traffic in the OR to be 6.27 door openings per procedure. After implementation of process improvements, the repeat audit of 250 procedures showed an overall traffic rate of 4.26 door openings per procedure. This resulted in a 32 percent reduction in OR traffic. <h3>Conclusions</h3> An audit tool is helpful in identifying common reasons for door openings during a surgical procedure. Results from the audit can successfully guide implementation of process improvements to decrease traffic in the OR.