World-class OR turnaround times: secrets uncovered

AORN Journal,  May, 2007  by John Olmstead,  Peggy Coxon,  Deborah Falcone,  Lisa Ignas,  Pam Foss

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In addition, Dr Hall's personality traits have a positive effect on his perioperative team members. He is a strong advocate of teamwork and leads by example; before the start of a procedure, he will assist the RNs and STs in small tasks that will help speed up the patient preparation process (eg, tying up surgical gowns, assisting in positioning patients, picking up linen from the OR floor). According to the perioperative staff members, however, the most important traits Dr Hall has that affect turnaround times are that he is helpful, polite, dedicated, and respectful to the OR staff members.

OUTCOMES OF THE EFFICIENT PROCESS

The costs associated with the efficient OR turnaround process are minimal compared to the increased revenue. The other, less-tangible benefits of this process also provide strong advantages for the hospital administration, surgeon, and staff members.

COSTS. Although the current model used by Dr Hall's team includes two RNs to help expedite the process, the extra RN and full-time equivalent cost is not mandatory to the efficient turnaround process. For many years, the perioperative team and Dr Hall utilized only one RN and still obtained excellent results. The team currently utilizes two RNs whenever possible, but it often relies on only one RN when department caseload necessitates reallocation of staff members.

The service provided by the floating anesthesiologist, though helpful, is not responsible for the bulk of the increased efficiency. For many years, no floating anesthesiologist was used. This extra position was added to allow breaks for anesthesia personnel and was not added specifically for Dr Hall. Thus, although this additional service is indeed helpful, the costs of employing the floating anesthesiologist are not factored into this model because they were incurred independently of the development of the efficient OR turnaround process. In addition, no extra equipment or supplies were required to produce faster turnaround times, so there were no additional equipment costs associated with this process.

BENEFITS. The increased efficiency of the OR turnaround process allows Dr Hall to schedule more procedures than other orthopedic surgeons in the same amount of time, resulting in increased revenue for the hospital (Table 2). Dr Hall routinely schedules six procedures each day in his reserved block time; other orthopedic surgeons schedule an average of three procedures a day in their respective block times. On average, Dr Hall's surgical team delivers $30,000 more revenue to the surgical department than other orthopedic surgical teams in the same amount of time. This efficiency benefits the surgeon as well as the hospital. Dr Hall is able to complete his surgical procedures by 1 PM and return to his office to see a full schedule of patients.

In this competitive age, surgeons have a plethora of hospitals and surgery centers vying for their business. Dr Hall has consistently filled block time at the Community Hospital, despite numerous increases in available OR centers in the area. The commitment of staff members and resources to ensuring an efficient process has helped greatly in the development of the long-term relationship between Dr Hall and the Community Hospital.