ASC turnover times

I manage an ASC with 2 ORs. We primarily do plastice surgery. We would like to achieve 15 minute turnovers. Is anyone able to achieve this? If so, how do you do staffing, procedure, etc?
Thanks!

Started by: Darcy bartlett (OR Manager/Supervisor) at November 7, 2011 (8:48 am)

Comments and Responses

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Indeed ! it is doable , key points is "team Work " and if the staff are proficient in their specific work assignments , although there are procedures that need more time within the target turn-over time of 15 minutes like ortho cases .

E. Cervantes (Other) at February 8, 2012 (12:21 pm) [last edited on March 5, 2012 (2:14 pm)]

Is that wheels out to wheels in? Need more of the definition for what you mean by turnover time.

Presuming wheels out to wheels in, if you have housekeeping staff ready to go when the patient leaves the room, you could approach making the number. I would suggest that everyone who enters the room have a specific task or tasks to complete and the order in which they need to be completed - like a NASCAR pit crew.

The other big question for plastic surgery is does anything get on the floor (flooding from from too much fluids being inserted or extracted during the procedure)? If you have to mop up a flood, you won't make 15 minutes.

S. Katz (Administrator/Director/Manager/Owner/Exec. Officer) at December 19, 2011 (5:10 pm)

Preparation and teamwork is the key to quick turnovers. Have all supplies ready ahead of time. We separate disposables into "open" and "hold" bins. That way, when opening, the nurse doesn't have to take the time to think about whether or not a supply needs to be opened. Also, our circulators review their patients' charts the day before surgery. (HUGE HELP!!) They can then take their time, making note of pertinent health information, and don't feel as if they are rushing when it is time for the patient interview. When they leave the OR,they go straight to their next patient. They will peek in to make sure everything is ready before bringing in the next patient. Having trust in your team is vital for this to work.

Catherine T. (OR Manager/Supervisor) at December 14, 2011 (3:13 pm)

I have seen less than 10 minute turn overs from the time a patient is out to the time the next one comes in the room from cases like Neuro to Ortho, as well as plastics. The key difference between negligence and effeciency is being prepared. One person (my experience was a CNA) would check case carts for the next case to make sure they are ready, then collect equipment that changes between cases. As the case winds down, get equipment/instruments/supplies ready to be taken out as soon as possible. Then clean effeciently, using all staff available, and redress the room for the next patient. When the room is clean, the CNA and any extras start opening for scrub, who scrubs as soon as a field is open. Most good scrubs don't get flustered having to get ready while the patient is being put to sleep and being prepped. For me, when I scrub, get the knife and bovie ready, then work forward until you are done. If the patient is ready BEFORE the room is empty, a quick hello and off to the room can be done within the 10 minute time frame. Know who is doing what and who is responsible to get things ready. Then, communicate. If there is a potential for a delay, let everyone know ahead of time and many delays can be avoided, or used to your advantage. Use time wisely, but don't rush. Get a routine and stick with it.

Mark B. (OR Manager/Supervisor) at December 9, 2011 (8:16 pm)

TUrn over of less than 15 min is doable, have the next team prepared or everything set and all team members know their next move, who is cleaning, who is coming out with the patient, wh is bringing in the next patient.
as the anaestheic assitant sets somebody brings in the next patient and the scrub nurse sets as the patient is being picked

Mildred O. (OR Manager/Supervisor) at November 22, 2011 (6:58 am)

We are a multispecialty ASC with a predominance of plastic cases. Our docs would be upset if our turnover time was 15 minutes...Nursing is usually able to turn the room over in 10 minutes or less. We don't have a large OR staff so team work and organization are vital.

Lorraine G. (Administrator/Director/Manager/Owner/Exec. Officer) at November 8, 2011 (8:29 am)

There is no compromise in quality if your people are proficient in there role in the OR. We frequently have less than 15 min turn over and it is because of planning and having proper resources. Everyone is playing on the same team. There are some procedures you just can't obtain this goal which is common sense. Our techs do the majority of the cleaning while the circulator is removing wrappers and prepairing the case when the room is ready to open. We run 3 OR's.
B.Franks RN, clinical resource nurse

B. Franks (Other) at November 8, 2011 (7:32 am) [last edited on November 8, 2011 (7:33 am)]

Totally agree with the wheels out to wheels in. We are an acute care facility and many of our cases have 15 minute turnover. Parallel tasking, i.e patient positioning while tech is setting up back table etc. enable us to do this.

Jayne Mitton (Administrator/Director/Manager/Owner/Exec. Officer) at November 7, 2011 (4:00 pm)

Several of our key accounts have reduced this time below 15 minutes. The way they did was an Stretcher-Chair-OR Table all-in-one device. By not having to transfer the patient, not having to clean an OR Table, the efficiency gained easily put these facilities into this goal turnover time. A transfer on/off an OR Table is at minimum of 6 minutes time, and risk of staff injury. Sometimes turnover times are reduced by thinking 'outside of the box,' and implementing more efficient processes. The resulting ROI was tremendous.

Michael M. (Other) at November 7, 2011 (2:40 pm)

The key is what is the definition of "turnover time." Once you have determined that definition, look at the variables.

Sandy B. (Administrator/Director/Manager/Owner/Exec. Officer) at November 7, 2011 (1:53 pm)

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