Ideas That Work: A Good Sign That You Shouldn’t Enter the OR

Practical pearls from your colleagues

Like many ASCs, OAM Surgery Center at MidTowne in Grand Rapids, Mich., is concerned about unnecessary traffic going in and out of its ORs. “Whether for supplies, staff breaks or communication, OR traffic puts our patients at increased risk for infections,” says OAM OR Manager Grace Patton MBA, BSN, RN, CNOR.

She and the team at the ortho-only ASC wanted to find out just how much traffic was entering and exiting its four ORs, and just as importantly, why. So the center’s college intern was assigned to observe and gather as much information as possible. “Using our intern was more beneficial to our center than a machine door counter system because we got tangible data,” she says. “It was an asset to have someone who could not only physically count the door swings but, more importantly, gather the reasons why the door swings were happening in order to match rationale to the numbers and offer potential solutions.”

The intern recorded data two rooms at a time, noting door swings and the reasons behind them. “We had her chart reasons, which included instrumentation, soft goods, leadership communication, allied health professionals, staff breaks and ‘miscellaneous,’” says Ms. Patton.

OAM broke the data down into hourly door openings and reasons why. “We found that leadership communication was at the top of the list — anything from delays to schedule changes, staff break information, even patient care questions,” says Ms. Patton.

OAM’s solution was what Ms. Patton calls “out-of-the-norm” traffic signs that the circulator in the OR can hang on the door outside. “The idea was to have something eye-catching to alert staff of OR traffic,” she says. “Our signs are not just pieces of plain white paper. They’re colorful and imaginative.”

Currently, circulators can choose from among four signs. One sign, “Surgery Under Construction,” is left up for every procedure. In addition, a total joints-specific stop sign is posted before and during every joint replacement surgery. The other two are “X-ray in use” and “Local procedures.” Easily cleanable clear plastic sign protectors hold each sign for display. As an additional access control measure, leadership was also instructed to always call into the OR first before entering.

Ms. Patton says the signs have helped decrease OR traffic, but notes that the eye-catching power of the signs needs replenishment from time to time. “We will continue to periodically update the signs in order for staff to not get complacent in their practice,” she says.

“Many surgery centers have, at one point or another, considered studying their OR traffic patterns,” says Ms. Patton. “I am hoping this study will help another center on how to collect OR traffic data.”OSM