Ideas That Work: Tune Up Your Turnovers With a Parallel Process

TURNOVER TASKS Everyone should be preparing for the next case at the same time.

Tune Up Your Turnovers With a Parallel Process

There's a lot to do in and around the OR between cases. In an effort to improve the efficiency of our room turnovers, and to bring their monthly average times down, we implemented a "parallel process" at our director's recommendation. Every surgical team member was assigned specific, standardized tasks to carry out simultaneously, based on their availability and location. Even some staff outside of the OR were recruited to our goal of achieving less-than-30-minute turnovers.

Think of it this way: You'll get more done in a shorter time if everyone's working on a piece of the process, than if everyone's waiting for someone else to finish a job so they can start theirs. In a linear process, for example, the staff cleaning up the room also have to take the cart to the decontamination room and pull supplies. In a parallel process, a sterile core tech can pull the next case for them and a nursing attendant can take away the cart that's been left outside the door. Also, the charge nurse can return medications to storage, pick up specimens and be the link that lets pre-op know when an OR is ready to receive a patient. Also, there's no waiting for the CRNA or resident to obtain the next patient's consent when the attending anesthesia provider has gone to get it, and (with the help of a nurse attendant) to roll the next patient back. We've even built each person's breaks into the process.

Using your turnover time and turnover staff in an interlocking, collaborative process will let you deliver care to more patients during the day and use OR time more cost-effectively with the resources you already have. By using this approach, we've reduced our turnover time to 28 minutes from an all-time average high of 39 minutes.

Stephanie Rico, RN, CNOR, CST
Lyndon B. Johnson General Hospital
Houston, Texas
[email protected]