Quality improvement project: reducing operating room turnover time for robotic surgery

Abstract

Background: Institutional goals for the Operating Room (OR) aim to decrease time between surgical cases to support surgical demand while improving revenue and profit. Turnover time (TOT), defined as the time between one patient exiting surgery to the time the next patient enters the room for surgery, is considered non-productive, thus a standard target for efficiency. Local Problem: Following TOT delays, surgeon time constraints, and staffing frustration, a Level III trauma center aimed to improve affordability and access within their OR. Methods: This quality improvement project implemented evidence-based practices, to create a sustainable decrease in TOT. This project utilized the Plan-Do-Study-Act method to engage stakeholders, implement best practices, and evaluate outcomes. Interventions: The project implemented role differentiation, parallel processing, and an assigned robot facilitator to achieve a 28-minute TOT. To accomplish this goal, we anticipated the primary nurse would retrieve the patient in the perioperative department 12 minutes after their return from PACU. Results: Prior to implementing the QI project, the OR's TOT averaged 34 minutes. Implementation of the evidence-based interventions resulted in an average TOT of 28 minutes. Conclusion: Results indicated the implementation of a secondary nurse with defined roles, along with adequate turnover assistance yielded an improvement in TOT. Staffing is a major contributor to implementing these changes and requires a motivated team to achieve positive outcomes.