Surgical Pit Crew: Optimizing Measurement and Accountability for Operating Room Turnover Time

Abstract

INTRODUCTION: With the aim of optimizing and standardizing operating room (OR) turnover processes and decreasing overall turnover time, we developed an innovative, staff-interactive method for measuring the time between surgical cases. METHODS: We broke down turnover into task-based sections and created buttons on the electronic medical record default pre-login screen within appropriate staff workflows to collect more granular data. We defined “Turnover Time” as the time between “Wheels out” of the previous case’s patient’s bed, to “Wheels in” of the patient’s bed for the case to follow. We created submeasures including “Cleanup Start,” “Cleanup Complete,” “Setup Start,” and “Room Ready for Patient” to calculate environmental services (EVS) response time, EVS cleaning time, Room Setup response time, and Room Setup time accordingly. RESULTS: Since developing these workflows, we have seen excellent adoption by staff members. We have also seen the times of EVS response and cleanup decrease significantly at our main hospital ORs (Fig. 1).Figure 1CONCLUSION: Delay in the OR can be costly to hospital systems, and 1 area where known delay occurs is during turnover. OR turnover can be a seemingly nebulous time between surgical cases. Many different and distinct staff personnel are often involved in many different and distinct processes during this time. By dividing our measurement of turnover time into the main processes that need to be completed, “Cleanup” and “Setup,” we were able to gain valuable insight into the cause of turnover delay and increase awareness and accountability of staff members to complete assigned tasks efficiently.