Importance of Efficiency in Operating Rooms
Operating room efficiency is a critical underpinning of any hospital’s or ambulatory surgery center’s ability to meet its fundamental responsibilities to patients. Improving operating room efficiency can play a role in bettering patient outcomes and in strengthening the facility’s financial position by reducing costs associated with materials and labor as well as by increasing case throughput.
The process of improving operating room efficiency is an ongoing one that depends in large part on the identification of existing inefficiencies. In this article, we’ll consider common problems in the operating room, including various preoperative, intraoperative, and postoperative issues, and conclude with a brief exploration of potential technology- and innovation-based solutions.
The items below represent common sources of preoperative inefficiency in hospitals and ambulatory surgery centers (ASCs).
Designating an appropriate amount of operating room time for each patient procedure is a key part of efficient scheduling and coordination. Staff members’ respective responsibilities should be planned and synchronized in advance.
Patient preparation encompasses a carefully orchestrated sequence of activities that includes everything from verifying patient details to transporting the patient to the operating room to anesthetization. As with other aspects of scheduling and coordination, myriad variables may compromise efficiency.
Another important preoperative consideration is the availability and readiness of equipment and supplies. Equipment and supplies should be easily accessible when and where they are needed.
Typical causes of intraoperative inefficiency in hospitals and ASCs include the items below.
Reliance on any number of inefficient or outdated processes can contribute to prolonged setup and turnover times, as can deviation from established best practices. Short-staffed shifts can disrupt schedules, too.
In addition to the ready availability and accessibility of required equipment and instrumentation, issues with equipment maintenance and functionality can hinder efficiency in the operating room. Equipment should be checked on a regular basis and serviced by appropriately licensed professionals.
Breakdowns or gaps in communication during surgery can have consequences that impact not only OR efficiency but patient health and safety. It is imperative that all roles and hierarchies be clearly defined and understood by everyone on the team.
Inefficiencies in hospitals and ASCs can also occur after surgery. Common postoperative problem areas include those mentioned below.
Overly long recovery room stays can be inefficient and costly to healthcare facilities, stretching limited resources. Likewise, discharge delays and bottlenecks represent potential organizational inefficiencies.
Additional possible areas of postoperative inefficiency relate to charting and record keeping. The use of real-time electronic health records (EHRs) facilitates patient documentation and simplifies fast retrieval.
Other common problems in the operating room or facility can arise preoperatively, intraoperatively, or postoperatively. Such inefficiencies include the following:
Intraoperative inefficiencies associated with surgical equipment and instruments can carry a particularly high risk of adversely impacting patent safety. Staff should not only ensure preparedness of equipment and instruments but also take all steps needed to maintain the sterile field. Protocols for protecting the sterile field include covering OR back tables and Mayo stands to safeguard instrument sterility, draping any equipment that may enter the surgical field, and draping the patient.
In general, it should be recognized that confusing or ambiguous communication between members of the perioperative team can lead to errors that may jeopardize patient safety. Clarity and coordination are crucial elements of an efficient OR.
Technology- and innovation-based solutions can be leveraged to address many common problems in the operating room. For example, year after year, new types of technologically advanced surgical equipment are being introduced for use in a growing number of medical procedures. Digital solutions are available to help hospitals and ASCs simplify scheduling and facilitate communication, and smart systems can be integrated for inventory management and tracking.
Innovative OR designs and layouts, meanwhile, place greater emphasis on ergonomic considerations, helping optimize utility and efficiency. The use of standardized single-use product solutions in the OR, such as innovative surgical drapes and covers, can help maintain the integrity of the sterile field while streamlining staff workflow.
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