Standard work procedures and compliance in the OR : a study on the effect of standard work in all surgery types

Abstract

The operating room (OR) department is one of the most expensive area to run in a hospital. The cost per minute to run the OR is $33/minute, so decreasing the time will save the hospital a significant amount, even if it is a minute per turnover. This research looks at to reducing the turnover time (non-operative time) and variation in the OR by using standardization. Data collection consisted of observation and interviews of the circulating nurses, surgical techs, and aides to identify causes of delays and long turnovers. It was determined that the turnover could be divided into two stages: cleaning of the room and setting up for the next surgery. With this in mind, the research team met with the cleaning staff (aides) to create a standard operating procedure. Preliminary tests with the cleaning procedure proved to be promising, and a full-scale implementation in all ORs and surgery types was carried out. Along with a cleaning procedure, standardization of tasks for the three staff types helped to decrease the time of cleaning the OR, setup of a room, and the overall time. The overall turnover time decreased by two minutes and standard deviation decreased by almost two minutes for all surgery types throughout the OR department. The decrease in time will allow the OR to hire more staff to increase the efficiency of setup for the turnovers. A decrease in standard deviation signifies more consistent turnovers which create more predicable times for scheduling in the future.