Patient Flow in Eye Centers w/2 ORs per Surgeon

How do the centers who have cataract surgeons using 2 operating rooms organize the flow of patients? Our center assigns a number to patients when they are admitted. All of the staff, including the surgeon and anesthesia team, know that the odd numbers go in room 1 and the even numbers in room 2. Of course we start with 1 and number in order to the last patient. It seems to be the easiest and most logical way to organize our patient flow.

However, one of our surgeons is very sensitive to the numbering and is concerned about the patient"™s perception of being number 7 or number 16. Although we do not announce to a patient their number, often patients overhear the staff reference to what number is next.

I would love to know what other centers are doing. I appreciate your responses.

(Posted on behalf of Donna White RN, MSN, MHA
Administrator/Director of Nursing
Madison Street Surgery Center
Spivack Vision Center)

Started by: Irene Tsikitas (Other) at June 21, 2010 (1:44 pm)

Comments and Responses

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We have 2 eye surgeons who routinely do 20-30 cases in a day, each using 2 OR's. Each case takes about 8 minutes which requires a fast turnover. Because our patients don't always arrive in the scheduled order, the pre op nurses clip a 'next' sign to the holding bay curtain so that the OR nurse knows which pt. to pick up. The physician also brings an assistant from his office who helps to facilitate the process by placing the correct lens in the office chart. This, of course, is checked with the surgeon in holding AND in the OR, when the time out is performed. Incidentally, the surgeons DO NOT want the pts. to know how many cases are scheduled, fearing they will perceive it as an 'assembly line'.

Lyn D. (Other) at August 21, 2010 (8:47 pm)

I have been in hundreds of surgery centers over the years and have seen just about all systems. Patients love being called by their "Favorite" name. Mrs Rose Smith may want to be called "Rosy". I love the name on the bonnett idea! You could expand this idea an put Rosy/LEFT or June/Right or Mikey/BOTH. The right/left eye rooms makes sense for set up, but I have seen 10 patients in a row that were right eyes, what do you do then? It is possible to set the room up to accomodate a right or left eye without changing equipment position or moving the scope. I highly recommend putting a DOT or mark over the eye to be operated on. I have seen a "Right" eye put into the wrong "Left" eye room. It was caught and totally disrupted the flow and confidence of the surgeon.

John Weymouth (Administrator/Director/Manager/Owner/Executive Officer) at July 16, 2010 (11:57 am)

We have colored numbers for each room. When one surgeon operates we use one number system. When the patient arrives, he/she is brought back to preop with the next number that is attached to the patient bay with velcro. The number is then written by the patient's name in the covered preop surgery schedule. When the circulators bring a patient to the OR, they cross out that number on the preop schedule. This way when the circulators and anesthesia providers come out, they can easily see which patient is next--matching up numbers on the schedule and the patient bays.
We also have the patients wear a first name tag on their foreheads, holding up their bonnets. This way noone refers to them as numbers.

Cherie Shevlin (Administrator/Director/Manager/Owner/Exec. Officer) at July 15, 2010 (4:29 pm)

We have the pre-op bays numbered, as we take a patient to pre-op we place the number of the bay they are admitted to next to their name on the schedule. We do all right eyes in O.R. 1 and all left eyes in O.R 2. The girl that makes out the schedule alternates patients arrival times to accomodate this flow.

Rosemary Groda (Administrator/Director/Manager/Owner/Executive Officer) at July 9, 2010 (5:34 pm)

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