IMPROVING OPERATING ROOM EFFICIENCY: A QUALITY IMPROVEMENT PROJECT

Surgical departments in healthcare organizations are costly. The economic viability of the hospital demands that operating rooms (OR) run efficiently. Leading causes of inefficiency are delays with first case starts (FCS) and unknown turnover time. The purpose of this quality improvement project was to improve OR efficiency by increasing compliance with FCS and establishing a baseline TOT for each surgical service. Methods included evaluating FCS before and after the implementation of a preoperative huddle 15 minutes prior to the first surgical case start time for all elective surgical procedures. Turnover time, the time needed to clean an OR after a surgical procedure, was also evaluated. Nurses completed a log identifying the reason for delays in FCSs. Environmental Services staff completed a log indicating start and end time for cleaning each OR. The results of the data were analyzed weekly and prominently displayed in the OR. During the 15-week study period, a huddle occurred for 82.9% of cases, almost 55% of cases started on-time, and delays with FCS decreased by 34%. The absence of the surgeon during the pre-operative huddle increased the delay in FCS fivefold (OR 5.663, 95% CI [3.051-10.510]). Delays to FCS cost $118, 344.52 with $90,755.00 attributed to surgeons. During this project, nursing leadership detected inefficiencies and delays to FCS by clearly identifying the reasons for delays. Interprofessional huddles that included the surgeon decreased surgical delays, promoted teamwork, and increased accountability with starting surgeries on-time.