Like a well-oiled machine, hospital operating room protocol could always use a tune-up. ORs rely on several moving parts to conduct surgeries safely and efficiently, and all of the moving parts have to be alert, careful and calm. Nancye Feistritzer, RN, MSN, associate hospital director at Vanderbilt University Medical Center in Nashville, Tenn., gives six best practices on how to keep the operating room running efficiently from pre-op to post-op.
1. Scheduling accuracy. Ms. Feistritzer says scheduling accuracy is of utmost importance, both from the perspective of the case time as well as the actual procedure to be done. The accuracy of the OR schedule sets the tone for the entire surgical process, including patient preparation.
2. Appropriate patient preparation. OR personnel must ensure the patient has been preoperatively assessed, via screening phone call, online screening or evaluation center screening, Ms. Feistritzer says. This includes appropriate lab work, EKGs, radiological exams and patient and family history among other items. She also states that having informed consent of what surgery will actually occur, and having the patient sign it, are musts.
3. Supply and instrumentation setup. Ms. Feistritzer says assuring appropriate and sterile supplies and instrumentation are available on the day of surgery coincides with the elements of Surgical Care Improvement Project protocol. The SCIP protocol incorporates core patient safety items such as correct site markings, patient identification and other descriptors to avoid wrong-site or wrong-person surgeries. "This can't be a trade-off for efficiency," she says.
4. Clear communication. Team effectiveness creates a calm environment, and that revolves around speaking and communicating well with each other, Ms. Feistritzer says. She notes that if there is poor communication among OR staff, it becomes significantly harder for the OR to run smoothly.
5. Timeouts. "The timeout is a critical opportunity to pause and be sure that the team is aligned about what is being done to whom in which location," Ms. Feistritzer says. Double- and triple-checking a patient's surgical information to avoid a mishap is worth the extra time. Ms. Feistritzer says staff at VUMC conducts its timeouts on electronic whiteboards to make sure that site marking, patient identification, draping and other essential elements are followed.
6. Management of OR technology. While technology has enhanced ORs, from computerized patient document systems to robotic and image-guided laparoscopic procedures, it has also created an information overload, Ms. Feistritzer says. "There is a great deal of information coming at members of the OR team," she says. "That's not to say it is technology that can't be managed. It's just to say there are more factors at play." Making sure to manage the data and technology effectively to avoid overwhelming feelings is essential, she says.
Related Articles on OR Efficiency:
4 Benefits of a Hybrid Operating Room
10 Important Findings for Hospital ORs
6 Steps to Build of a "Culture of Safety" in the Hospital Operating Room
1. Scheduling accuracy. Ms. Feistritzer says scheduling accuracy is of utmost importance, both from the perspective of the case time as well as the actual procedure to be done. The accuracy of the OR schedule sets the tone for the entire surgical process, including patient preparation.
2. Appropriate patient preparation. OR personnel must ensure the patient has been preoperatively assessed, via screening phone call, online screening or evaluation center screening, Ms. Feistritzer says. This includes appropriate lab work, EKGs, radiological exams and patient and family history among other items. She also states that having informed consent of what surgery will actually occur, and having the patient sign it, are musts.
3. Supply and instrumentation setup. Ms. Feistritzer says assuring appropriate and sterile supplies and instrumentation are available on the day of surgery coincides with the elements of Surgical Care Improvement Project protocol. The SCIP protocol incorporates core patient safety items such as correct site markings, patient identification and other descriptors to avoid wrong-site or wrong-person surgeries. "This can't be a trade-off for efficiency," she says.
4. Clear communication. Team effectiveness creates a calm environment, and that revolves around speaking and communicating well with each other, Ms. Feistritzer says. She notes that if there is poor communication among OR staff, it becomes significantly harder for the OR to run smoothly.
5. Timeouts. "The timeout is a critical opportunity to pause and be sure that the team is aligned about what is being done to whom in which location," Ms. Feistritzer says. Double- and triple-checking a patient's surgical information to avoid a mishap is worth the extra time. Ms. Feistritzer says staff at VUMC conducts its timeouts on electronic whiteboards to make sure that site marking, patient identification, draping and other essential elements are followed.
6. Management of OR technology. While technology has enhanced ORs, from computerized patient document systems to robotic and image-guided laparoscopic procedures, it has also created an information overload, Ms. Feistritzer says. "There is a great deal of information coming at members of the OR team," she says. "That's not to say it is technology that can't be managed. It's just to say there are more factors at play." Making sure to manage the data and technology effectively to avoid overwhelming feelings is essential, she says.
Related Articles on OR Efficiency:
4 Benefits of a Hybrid Operating Room
10 Important Findings for Hospital ORs
6 Steps to Build of a "Culture of Safety" in the Hospital Operating Room